PINE RIDGE EXTENDED CARE CENTER LLC NPI 1336206010

NPI Information

NPI: 1336206010
Provider Name: PINE RIDGE EXTENDED CARE CENTER, LLC

Doing Business As: PINE RIDGE EXTENDED CARE CENTER

Classification: Respite Care - 385H00000X
Entity Type: Organization
Address:
119 BASTILLE DR
PAGOSA SPRINGS, CO
ZIP 81147
Phone: (970) 731-4330
Get Directions

PINE RIDGE EXTENDED CARE CENTER, LLC is a respite care in Pagosa Springs, CO. PINE RIDGE EXTENDED CARE CENTER, LLC NPI is 1336206010. The provider is registered as an organization entity type.
The provider Is Doing Business As Pine Ridge Extended Care Center.

The provider's business location address is:

119 BASTILLE DR
PAGOSA SPRINGS, CO
ZIP 81147-388
Phone: (970) 731-4330
Fax: (970) 731-4046

The provider's authorized official is Mary Brooks .
The authorized official title is Administrator and has the following contact phone number (970) 731-4330.

The enumeration date for this NPI number is 1/2/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	385H00000X	Respite Care		0105	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	04183539	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »