Organization
SOUTHERN TELLER COUNTY HEALTH SERVICES DISTRICT
Active
Other names
Cripple Creek Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE COWAN NHA (NURSING HOME ADMINISTRATOR)
(719) 689-2931
Entity
Organization
Contact information
Practice address
700 NORTH A STREET, CRIPPLE CREEK, CO 80813-0397
(719) 689-2931
(719) 689-3702
Mailing address
PO BOX 397, 700 NORTH A STREET, CRIPPLE CREEK, CO 80813-0397
(719) 689-2931
(719) 689-3702
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0249
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05654215
—
CO
Enumeration date
07/14/2005
Last updated
02/07/2019
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