Organization
PEAK VISTA COMMUNITY HEALTH CENTERS
Active
Organization
PEAK VISTA COMMUNITY HEALTH CENTERS
Active
Parent organization
PEAK VISTA COMMUNITY HEALTH CENTERS
Other names
Health Center at South Circle
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEAK VISTA COMMUNITY HEALTH CENTERS
Authorized official
TRACY NARVET MCMANUS (CFO)
(719) 344-6188
Entity
Organization
Contact information
Practice address
2864 S CIRCLE DR, SUITE 450, COLORADO SPRINGS, CO 80906
(719) 632-5700
(719) 344-7867
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917
(719) 632-5700
(719) 344-7865
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CO
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02105055
—
CO
05
—
05638267
—
CO
Enumeration date
12/30/2015
Last updated
09/12/2018
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