Provider Demographics
NPI:1013665447
Name:PARK POINT HEALTHCARE LLC
Entity Type:Organization
Organization Name:PARK POINT HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:2764 COMPASS DR STE 244
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8722
Mailing Address - Country:US
Mailing Address - Phone:970-208-1430
Mailing Address - Fax:970-249-5890
Practice Address - Street 1:2764 COMPASS DR STE 244
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8722
Practice Address - Country:US
Practice Address - Phone:970-208-1430
Practice Address - Fax:970-249-5890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care