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Organization

PONDEROSA CARE COMMUNITIES C, LLC

Active
Other names
Sierra Rehabilitation and Care Community
Organization subpart
No

Provider details

NPI number
Authorized official
MARY KORETKE (DIRECTOR OF REIMBURSEMENT)
(720) 974-6278
Entity
Organization

Contact information

Practice address
1432 DEPEW ST, LAKEWOOD, CO 80214-2237
(303) 238-1375
(303) 238-0852
Mailing address
1432 DEPEW ST, LAKEWOOD, CO 80214-2237
(303) 238-1375
(303) 238-0852

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
020423
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
23703865
CO
Enumeration date
02/11/2016
Last updated
05/02/2016
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