Organization
BLAKE AVENUE OPERATIONS, LLC
Active
Other names
Glenwood Springs Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL SILVER (DIRECTOR OF A/R-COLORADO)
(949) 449-2500
Entity
Organization
Contact information
Practice address
2305 BLAKE AVE, GLENWOOD SPRINGS, CO 81601-4325
(619) 876-9252
Mailing address
26522 LA ALAMEDA STE 300, MISSION VIEJO, CA 92691-8302
(949) 449-2500
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34805036
—
CO
Enumeration date
05/18/2016
Last updated
02/07/2019
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