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SHADOW MOUNTAIN MANAGEMENT NPI 1780198598


NPI Information

NPI: 1780198598
Provider Name: SHADOW MOUNTAIN MANAGEMENT

Doing Business As: HILDEBRAND CARE CENTER

Classification: Respite Care - 385H00000X
Entity Type: Organization

CLIA Number: 06D0676469

Address:
1401 PHAY AVE
CANON CITY, CO
ZIP 81212
Phone: (719) 275-8656
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SHADOW MOUNTAIN MANAGEMENT is a respite care in Canon City, CO. SHADOW MOUNTAIN MANAGEMENT NPI is 1780198598. The provider is registered as an organization entity type.
The provider Is Doing Business As Hildebrand Care Center.

The provider's business location address is:

1401 PHAY AVE
CANON CITY, CO
ZIP 81212-303
Phone: (719) 275-8656
Fax: (719) 275-8858

The provider's authorized official is Robin Roberts .
The authorized official title is Office Manager and has the following contact phone number (719) 275-8656.

The CLIA number assigned to this NPI record is 06D0676469 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/1/2017 and was last updated on 12/1/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1385H00000XRespite Care020666COLORADOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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