Provider Demographics
NPI:1649482415
Name:STERLING MEDCARE HOME & COMMUNITY BASED SERVICES, INC.
Entity type:Organization
Organization Name:STERLING MEDCARE HOME & COMMUNITY BASED SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-522-6807
Mailing Address - Street 1:614 S 10TH AVE
Mailing Address - Street 2:P.O. BOX 791
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-3415
Mailing Address - Country:US
Mailing Address - Phone:970-522-6807
Mailing Address - Fax:970-522-2807
Practice Address - Street 1:614 S 10TH AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-3415
Practice Address - Country:US
Practice Address - Phone:970-522-6807
Practice Address - Fax:970-522-2807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO68676859Medicaid