1184220485 NPI number — TOTAL LONGTERM CARE, INC.

Table of content: (NPI 1184220485)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184220485 NPI number — TOTAL LONGTERM CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL LONGTERM CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184220485
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/20/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8950 E LOWRY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80230-7030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-091-2719
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1303 E 11TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOVELAND
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80537-5051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-800-5500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/10/2020

Additional Information

Authorized Official

Authorized Official Last Name:
WASHINGTON
Authorized Official First Name:
GAYLE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CREDENTIALING COORDINATOR
Authorized Official Telephone Number:
303-912-7193

Provider Taxonomy Codes

  • Taxonomy code: 251T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 302F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 21904863 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com