Provider Demographics
NPI:1982761664
Name:ANIMAS EQUITY, INC
Entity Type:Organization
Organization Name:ANIMAS EQUITY, INC
Other - Org Name:THE VALLEY INN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMISTON-BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-533-9031
Mailing Address - Street 1:211 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:MANCOS
Mailing Address - State:CO
Mailing Address - Zip Code:81328-9079
Mailing Address - Country:US
Mailing Address - Phone:970-533-9031
Mailing Address - Fax:
Practice Address - Street 1:211 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:MANCOS
Practice Address - State:CO
Practice Address - Zip Code:81328-9079
Practice Address - Country:US
Practice Address - Phone:970-533-9031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0158385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04181814Medicaid