Organization
SSC FORT COLLINS LEMAY AVENUE OPERATING COMPANY LLC
Active
Parent organization
SSC FORT COLLINS LEMAY AVENUE OPERATING COMPANY LLC
Other names
Fort Collins Health Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSC FORT COLLINS LEMAY AVENUE OPERATING COMPANY LLC
Authorized official
KEN PITTS (DIRECTOR REIMBURSEMENT)
(832) 467-6793
Entity
Organization
Contact information
Practice address
1000 S LEMAY AVE, FORT COLLINS, CO 80524-3914
(970) 482-7925
(970) 493-1686
Mailing address
5300 W SAM HOUSTON PKWY N STE 100, HOUSTON, TX 77041-5162
(832) 467-6000
(832) 467-8500
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
1291
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000159189
—
CO
Enumeration date
04/09/2018
Last updated
04/09/2018
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