Provider Demographics
NPI:1780367037
Name:WILLCAT
Entity type:Organization
Organization Name:WILLCAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-596-0076
Mailing Address - Street 1:2060 PIMA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80915-1748
Mailing Address - Country:US
Mailing Address - Phone:719-596-0076
Mailing Address - Fax:719-597-1936
Practice Address - Street 1:2060 PIMA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80915-1748
Practice Address - Country:US
Practice Address - Phone:719-596-0076
Practice Address - Fax:719-597-1936
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLCAT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility