Organization
CONEJOS COUNTY HOSPITAL LTCU CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRIGITTE INGE FOUST (HIPPA PRIVACY SECURITY OFFICER)
(719) 274-6029
Entity
Organization
Contact information
Practice address
19021 STATE HWY, LA JARA, CA 81140
(719) 274-6058
(719) 274-6003
Mailing address
19021 STATE HWY, PO BOX 639, LA JARA, CA 81140
(719) 274-6058
(719) 274-6003
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71885706
—
CO
Enumeration date
03/20/2006
Last updated
08/22/2020
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