Organization
EATON FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS DAHLEN (SR VICE PRESIDENT FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
100 S CHERRY AVE UNIT 1, EATON, CO 80615-8256
(970) 454-3838
(970) 454-1265
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21176043
—
CO
Enumeration date
06/30/2006
Last updated
08/22/2020
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