| Vitalcare Corporation | |
|
1400 W 122nd Ave Ste 140 Westminster CO 80234-3440 | |
| (720) 458-0642 | |
| (720) 815-3372 |
| Full Name | Vitalcare Corporation |
|---|---|
| Speciality | Counselor |
| Location | 1400 W 122nd Ave Ste 140, Westminster, Colorado |
| Authorized Official Name and Position | Matthew Dolph (CEO) |
| Authorized Official Contact | 7204580643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitalcare Corporation 1400 W 122nd Ave Ste 140 Westminster CO 80234-3440 Ph: (720) 458-0642 | Vitalcare Corporation 1400 W 122nd Ave Ste 140 Westminster CO 80234-3440 Ph: (720) 458-0642 |
| NPI Number | 1083180012 |
|---|---|
| Provider Enumeration Date | 10/17/2018 |
| Last Update Date | 09/21/2020 |
| Certification Date | 09/21/2020 |
| Medicare PECOS PAC ID | 4981091063 |
|---|---|
| Medicare Enrollment ID | O20220419001639 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083180012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 225700000X | Massage Therapist | (* (Not Available)) | Secondary |
| Provider Name | Janet Jerome |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760667919 PECOS PAC ID: 8426132580 Enrollment ID: I20120109000616 |
| Provider Name | Stacey G Hoffman-hiatt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588095541 PECOS PAC ID: 5294964128 Enrollment ID: I20140218001403 |
| Provider Name | Lisa Kish Pittman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013578947 PECOS PAC ID: 0042607129 Enrollment ID: I20221206000851 |
| Provider Name | Meredith D Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154048411 PECOS PAC ID: 4981074465 Enrollment ID: I20221227000811 |
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