Organization
FAIRACRES MANOR, INC
Active
Other names
Fairacres Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY KORETKE (DIRECTOR OF REIMBURSEMENT)
(720) 974-6278
Entity
Organization
Contact information
Practice address
1700 18TH AVE, GREELEY, CO 80631-5134
(970) 353-3370
(970) 353-9347
Mailing address
12136 W BAYAUD AVENUE, SUITE 200, LAKEWOOD, CO 80228-2115
(303) 987-3088
(303) 987-0434
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0576
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05653423
—
CO
Enumeration date
01/11/2006
Last updated
02/05/2010
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