NPI 1497134456
Diversicare of Canon City, LLC
Practice location
- Address
- 515 Fairview Ave, Canon City, CO 81212-2863
- Phone
- (719) 275-0665
- Fax
- (615) 620-7875
Authorised official
- Name
- Kelly J Gill
- Title
- President & Ceo
- Phone
- (615) 771-7575
Registered specialties
Skilled Nursing Facility
Primary
Registry record
- NPI
- 1497134456
- Entity type
- Organization
- NPI issued
- 23 May 2015
- Record last updated
- 23 May 2015
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.