Provider Demographics
NPI:1932178985
Name:COLUMBINE CARE CENTER WEST INC.
Entity Type:Organization
Organization Name:COLUMBINE CARE CENTER WEST INC.
Other - Org Name:COLUMBINE WEST HEALTH & REHAB FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:WINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-221-2273
Mailing Address - Street 1:940 WORTHINGTON CIR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1840
Mailing Address - Country:US
Mailing Address - Phone:970-221-9156
Mailing Address - Fax:
Practice Address - Street 1:940 WORTHINGTON CIR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1840
Practice Address - Country:US
Practice Address - Phone:970-221-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1026314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05650833Medicaid
COC809804Medicare PIN
CO05650833Medicaid