Provider Demographics
NPI:1245362169
Name:PIKES PEAK HOSPICE AND PALLIATIVE CARE INC
Entity type:Organization
Organization Name:PIKES PEAK HOSPICE AND PALLIATIVE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DARVALICS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-633-3400
Mailing Address - Street 1:2550 TENDERFOOT HILL ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3998
Mailing Address - Country:US
Mailing Address - Phone:719-633-3400
Mailing Address - Fax:719-633-3800
Practice Address - Street 1:2550 TENDERFOOT HILL ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3998
Practice Address - Country:US
Practice Address - Phone:719-633-3400
Practice Address - Fax:719-633-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO66132045Medicaid
CO66132045Medicaid