GENGREENMOUNTAIN LLC NPI 1366084212

NPI Information

  • NPI: 1366084212
  • Provider Name: GENGREENMOUNTAIN LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: MONTAGE RIDGE
  • CLIA Number: 06D2203132
  • Address: 12791 W ALAMEDA PKWY
    LAKEWOOD, CO
    ZIP 80228
  • Phone: (503) 652-0750

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NPI Details

GENGREENMOUNTAIN LLC is an assisted living facility in Lakewood, CO. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. GENGREENMOUNTAIN LLC NPI is 1366084212. The provider is registered as an organization entity type.
The provider Is Doing Business As Montage Ridge.

The provider's business location address is:

12791 W ALAMEDA PKWY
LAKEWOOD, CO
ZIP 80228-838
Phone: (503) 652-0750

The provider's authorized official is Rebecca Stayner .
The authorized official title is Director Of Compliance and has the following contact phone number (503) 594-2263.

The CLIA number assigned to this NPI record is 06D2203132 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2019 and was last updated on 11/15/2023.

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
1314000000XSkilled Nursing FacilityNo
2310400000XAssisted Living FacilityYes

What is NPI?

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This page was last updated on: 3/30/2025

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