Basic Information
| Provider Information | |||||||||
| NPI: | 1952423022 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HUERFANO COUNTY HOSPITAL DISTRICT | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SPANISH PEAKS VOICE CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23500 US HIGHWAY 160 | ||||||||
| Address2: | |||||||||
| City: | WALSENBURG | ||||||||
| State: | CO | ||||||||
| PostalCode: | 810899524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7197385100 | ||||||||
| FaxNumber: | 7197385168 | ||||||||
| Practice Location | |||||||||
| Address1: | 129 KANSAS AVE | ||||||||
| Address2: | B1 | ||||||||
| City: | WALSENBURG | ||||||||
| State: | CO | ||||||||
| PostalCode: | 810891818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7197385191 | ||||||||
| FaxNumber: | 7197382732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 12/30/2016 | ||||||||
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| AuthorizedOfficialLastName: | MONTOYA | ||||||||
| AuthorizedOfficialFirstName: | LIONEL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9717385100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 253Z00000X | Y | Agencies | In Home Supportive Care |
No ID Information.