Organization
BUCKEYE M, LLC
Active
Other names
Mesa Vista of Boulder
Organization subpart
No
Provider details
NPI number
Authorized official
JAY MOSKOWITZ (PRESIDENT)
(303) 238-3838
Entity
Organization
Contact information
Practice address
2121 MESA DR, BOULDER, CO 80304-3621
(303) 442-4037
(303) 442-2348
Mailing address
12136 W BAYAUD AVE, SUITE 200, LAKEWOOD, CO 80228-2115
(303) 238-3838
(303) 987-0434
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0638
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05656400
—
CO
Enumeration date
11/03/2005
Last updated
04/25/2016
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