Organization
33 SOUTHMOOR PROPERTIES, INC
Active
Other names
Wheatridge Manor Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KORETKE (DIRECTOR OF REIMBURSEMENT)
(720) 974-6278
Entity
Organization
Contact information
Practice address
2920 FENTON ST, WHEAT RIDGE, CO 80214-8116
(303) 238-0481
(303) 233-3775
Mailing address
2920 FENTON ST, WHEAT RIDGE, CO 80214-8116
(303) 238-0481
(303) 233-3775
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
020436
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34376020
—
CO
Enumeration date
01/25/2016
Last updated
01/25/2016
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