Provider Demographics
NPI:1962615443
Name:RICE, JAMES
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:RICE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3291 LOMBARDY LANE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:CO
Mailing Address - Zip Code:81520
Mailing Address - Country:US
Mailing Address - Phone:970-434-8919
Mailing Address - Fax:970-434-7683
Practice Address - Street 1:3291 LOMBARDY LANE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:CO
Practice Address - Zip Code:81520
Practice Address - Country:US
Practice Address - Phone:970-434-8919
Practice Address - Fax:970-434-7683
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04182226Medicaid