Provider Demographics
NPI:1144674284
Name:PEAK COMMUNITY SERVICES, INC.
Entity type:Organization
Organization Name:PEAK COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-689-7136
Mailing Address - Street 1:343 W DRAKE RD STE 115
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2880
Mailing Address - Country:US
Mailing Address - Phone:970-689-7136
Mailing Address - Fax:970-237-4049
Practice Address - Street 1:343 W DRAKE RD STE 115
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2880
Practice Address - Country:US
Practice Address - Phone:970-689-7136
Practice Address - Fax:970-237-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X
CO0828528385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0828528Medicaid