Organization
PONDEROSA CARE COMMUNITIES A, LLC
Active
Other names
North Star Rehabilitation and Care Community
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY KORETKE (DIRECTOR OF REIMBURSEMENT)
(303) 987-3088
Entity
Organization
Contact information
Practice address
3185 W ARKANSAS AVE, DENVER, CO 80219-4004
(303) 922-1169
(303) 934-0220
Mailing address
12136 W BAYAUD AVE, SUITE 200, LAKEWOOD, CO 80228-2115
(303) 987-3088
(303) 987-0434
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0169
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26554739
—
CO
Enumeration date
01/09/2006
Last updated
01/11/2011
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