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Organization

FREMONT COUNTY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STEVEN A CLIFTON (DIRECTOR)
(719) 275-2318
Entity
Organization

Contact information

Practice address
172 JUSTICE CENTER RD, CANON CITY, CO 81212-9354
(719) 275-2318
(719) 275-5206
Mailing address
172 JUSTICE CENTER RD, CANON CITY, CO 81212-9354
(719) 275-2318
(719) 275-5206

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
09000225
CO
343900000X
Non-emergency Medical Transport (VAN)
Primary
06200224
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06200224
CO
05
09000225
CO
Enumeration date
01/16/2007
Last updated
09/11/2025
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