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Organization

LAS ANIMAS COUNTY REHABILITATION CENTER

Active
Other names
Alta Vista Alternatives
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DUANE ROY (EXECUTIVE DIRECTOR)
(719) 846-3388
Entity
Organization

Contact information

Practice address
415 S INDIANA AVE, TRINIDAD, CO 81082-3126
(719) 846-4631
(719) 846-4608
Mailing address
1205 CONGRESS DR, TRINIDAD, CO 81082-1283
(719) 846-3388
(719) 846-4543

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
04K570
CO
261QA0600X
Adult Day Care Clinic/Center
Primary
343900000X
Non-emergency Medical Transport (VAN)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02133873
CO
05
09140070
CO
05
09144247
CO
05
24353345
CO
Enumeration date
06/24/2016
Last updated
02/03/2017
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