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NPI 1972049245 · Custodial Care Facility · Canon City, CO
Provider details
- NPI number
- 1972049245
- Entity type
- Organization
- Primary specialty
- Custodial Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Trudy Sicotte, Nurse Practitioner
- License
- 0004895 (CO)
Mailing address
13955 Murphy Rd
Peyton, CO 80831-9510
Registry dates
- Enumerated
- 2017-01-11
- Last updated
- 2017-01-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.