Provider Demographics
NPI:1316122716
Name:ASPEN VALLEY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:ASPEN VALLEY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-544-7695
Mailing Address - Street 1:275 CASTLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1159
Mailing Address - Country:US
Mailing Address - Phone:970-544-1530
Mailing Address - Fax:970-544-1364
Practice Address - Street 1:275 CASTLE CREEK RD
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1159
Practice Address - Country:US
Practice Address - Phone:970-544-1530
Practice Address - Fax:970-544-1364
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPEN VALLEY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-03
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAL-0366310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
COAL-0366OtherSTATE OF COLORADO
CO04182366Medicaid