NPIMap

Organization Active NPI

Total Longterm Care, Inc

  • PACE Provider Organization
  • Pueblo, CO
National Provider Identifier
1396332946
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
TOTAL LONGTERM CARE, INC
Doing business as
InnovAge Colorado PACE-Pueblo
Practice address
401 W Northern Ave
Pueblo, CO 81004-3111
Phone
(719) 553-0400
NPI assigned
Dec 30, 2020
Organization subpart
Yes
Parent organization
TOTAL LONG TERM CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Gayle M Washington
Title
Credentialing Coordinator
Phone
(303) 912-7193

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

401 W Northern Ave
Pueblo, CO 81004-3111

Mailing address

8950 E Lowry Blvd
Denver, CO 80230-7030
Phone (303) 912-7193

Other identifiers 1

IdentifierTypeStateIssuer
O1336363MedicaidCO

Other names 1

  • InnovAge Colorado PACE-Pueblo Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2178984Total Longterm Care, Inc401 W Northern Ave, Pueblo, CO 81004Certificate of waiverFeb 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Total Longterm Care Inc9 organizations share this tax ID, including this one
Part of
Total Longterm Care Inc

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1396332946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 E LOWRY BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307030",
            "telephone_number": "303-912-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W NORTHERN AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043111",
            "telephone_number": "719-553-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL LONGTERM CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOTAL LONG TERM CARE",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "303-912-7193",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "O1336363",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InnovAge Colorado PACE-Pueblo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.