Organization
FAIRACRES MANOR, INC
Active
Other names
Fairacres Manor
Organization subpart
No
Provider details
NPI number
Authorized official
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
1700 18TH AVE, GREELEY, CO 80631-5134
(970) 353-3370
(970) 353-9347
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
020369
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4139994
—
CO
Enumeration date
11/05/2015
Last updated
01/09/2017
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