| Temporary Site -springs Rescue Mission | |
|
5 W Las Vegas St Colorado Springs CO 80903-4217 | |
| (719) 632-5700 | |
| Not Available |
| Full Name | Temporary Site -springs Rescue Mission |
|---|---|
| Speciality | Clinic/Center |
| Location | 5 W Las Vegas St, Colorado Springs, Colorado |
| Authorized Official Name and Position | Ryan Spillane (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7193447135 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Temporary Site -springs Rescue Mission 3205 N Academy Blvd Ste 130 Colorado Springs CO 80917-5152 Ph: (719) 632-5700 | Temporary Site -springs Rescue Mission 5 W Las Vegas St Colorado Springs CO 80903-4217 Ph: (719) 632-5700 |
| NPI Number | 1437772365 |
|---|---|
| Provider Enumeration Date | 05/27/2020 |
| Last Update Date | 03/06/2023 |
| Medicare PECOS PAC ID | 4688583974 |
|---|---|
| Medicare Enrollment ID | O20200615002970 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437772365 | NPI | - | NPPES |
| 05638267 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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