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Organization

COLORADO MEDICAL INVESTORS, LLC

Active
Other names
Canon Lodge Care Center
Organization subpart
No

Provider details

NPI number
Authorized official
CINDY S CROSS (ASSISTANT SECRETARY)
(423) 473-5867
Entity
Organization

Contact information

Practice address
905 HARDING AVE, CANON CITY, CO 81212-2147
(719) 275-4106
(719) 275-2895
Mailing address
3001 KEITH ST NW, CLEVELAND, TN 37312-3713
(423) 473-5751
(423) 339-8342

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0418
CO
385H00000X
Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05652631
CO
Enumeration date
08/05/2006
Last updated
09/15/2021
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