State of Colorado

NPI #1114085875 in Monte Vista, Colorado

Provider Information

NPI Number
1114085875
Entity Type
Organization
Organization Name
State of Colorado
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Dec 5, 2006
Last Updated
Jul 12, 2021

Practice Location

Address
3749 SHERMAN AVE
ZIP Code
81144-9403
Phone
(719) 852-5118

Authorized Official

Name
MS. MINDY MONTAGUE
Title
ADMINISTRATOR
Phone
(719) 852-5118

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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