Organization
FOREST RIDGE SENIOR LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLEY WHITAKER (CHIEF OPERATIONS OFFICER)
(505) 369-0079
Entity
Organization
Contact information
Practice address
16006 W JS HIGHWAY 24, WOODLAND PARK, CO 80863
(719) 686-6500
Mailing address
8820 HORIZON BLVD NE, ALBUQUERQUE, NM 87113-1689
(505) 369-0079
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
02D453
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02D453
DEPT. OF PUBLIC HEALTH AND ENVIRONMENT
CO
Enumeration date
10/08/2015
Last updated
06/13/2016
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