Provider Demographics
NPI:1427405935
Name:VERACARE HOSPICE OF COLORADO SPRINGS LLC
Entity type:Organization
Organization Name:VERACARE HOSPICE OF COLORADO SPRINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MIKULS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-544-8800
Mailing Address - Street 1:5266 OFFICE PARK BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-3442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5445 MARK DABLING BLVD STE 205
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3826
Practice Address - Country:US
Practice Address - Phone:719-419-5595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based