Organization
MESA VISTA HEALTHCARE LLC
Active
Other names
Boulder Post Acute
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETART)
(385) 988-3319
Entity
Organization
Contact information
Practice address
2121 MESA DR, BOULDER, CO 80304-3621
(303) 442-4037
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000001
HOSPITAL BACK UP (HBU) PROGRAM
CO
Enumeration date
06/26/2024
Last updated
01/06/2025
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