Organization
PONCHA MOOR HEALTHCARE, INC
Active
Other names
SKYLINE RIDGE HEALTH AND REHABILITATION
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (SECRETARY)
(949) 540-1249
Entity
Organization
Contact information
Practice address
515 FAIRVIEW AVE, CANON CITY, CO 81212-2863
(719) 275-0665
(719) 275-6225
Mailing address
515 FAIRVIEW AVE, CANON CITY, CO 81212-2863
(719) 275-0665
(719) 275-6225
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/05/2026
Last updated
08/05/2026
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