State of Colorado

NPI #1093702722 in Rifle, Colorado

Provider Information

NPI Number
1093702722
Entity Type
Organization
Organization Name
State of Colorado
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Sep 27, 2005
Last Updated
Feb 19, 2010

Practice Location

Address
851 EAST 5TH STREET
City
Rifle
ZIP Code
81650-2941
Phone
(970) 625-0842

Authorized Official

Name
NIKKI M MAYNARD, RHIT
Title
MEDICAL RECORDS TECHNICIAN
Phone
(970) 625-0842

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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