COMMUNITY ASSISTED LIVING INC NPI 1437110509

NPI Information

NPI: 1437110509
Provider Name: COMMUNITY ASSISTED LIVING, INC

Doing Business As: COTTONWOOD RIDGE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

Address:
1122 S 12TH ST
ROCKY FORD, CO
ZIP 81067
Phone: (719) 854-3667
Get Directions

COMMUNITY ASSISTED LIVING, INC is an assisted living facility in Rocky Ford, 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. COMMUNITY ASSISTED LIVING, INC NPI is 1437110509. The provider is registered as an organization entity type.
The provider Is Doing Business As Cottonwood Ridge.

The provider's business location address is:

1122 S 12TH ST
ROCKY FORD, CO
ZIP 81067-400
Phone: (719) 854-3667
Fax: (719) 254-3823

The provider's authorized official is Donald Kanen .
The authorized official title is Cfo and has the following contact phone number (719) 589-2063.

The CLIA number assigned to this NPI record is 06D2238123 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2006 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	310400000X	Assisted Living Facility		AL-0001	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	7173825	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: 11/14/2023

NPI Synchronization or Removal

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