1912108523 NPI number — ACCESS AND ABILITY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912108523 NPI number — ACCESS AND ABILITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCESS AND ABILITY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912108523
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 305
Provider Second Line Business Mailing Address:
510 12TH STREET
Provider Business Mailing Address City Name:
GILCREST
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80623-0305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-545-1344
Provider Business Mailing Address Fax Number:
970-737-0517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 12TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GILCREST
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80623-0305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-545-1344
Provider Business Practice Location Address Fax Number:
970-737-0517
Provider Enumeration Date:
05/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WARNE
Authorized Official First Name:
MENDA
Authorized Official Middle Name:
K
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
970-545-1344

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 21532826 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com