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Find providers by NPI
Organization

STATE OF COLORADO

Active
Parent organization
STATE OF COLORADO
Other names
Colorado Veterans Community Living Center Homelake
Organization subpart
Yes

Provider details

NPI number
Legal business name
STATE OF COLORADO
Authorized official
GINGER BUTERO (ACCOUNTANT)
(719) 852-5118
Entity
Organization

Contact information

Practice address
3749 SHERMAN AVE, MONTE VISTA, CO 81144-9403
(719) 852-8211
(719) 852-3881
Mailing address
PO BOX 97, HOMELAKE, CO 81135-0097
(719) 852-8211
(719) 852-3881

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000179367
CO
Enumeration date
04/21/2021
Last updated
04/21/2021
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