Organization
PINE RIDGE EXTENDED CARE CENTER
Active
Organization
PINE RIDGE EXTENDED CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY J BROOKS RN (NUSING HOME ADMINISTRATOR)
(970) 731-4330
Entity
Organization
Contact information
Practice address
119 BASTILLE DR, PAGOSA SPRINGS, CO 81147-9388
(970) 731-4330
(970) 731-4046
Mailing address
119 BASTILLE DR, PAGOSA SPRINGS, CO 81147-9388
(970) 731-4330
(970) 731-4046
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL0228
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04143434
—
CO
Enumeration date
07/07/2005
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up