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NPI Code Detail

MEDICARE: CENTRE AVENUE HEALTH AND REHAB LLC

MEDICARE: CENTRE AVENUE HEALTH AND REHAB LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1801785415
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRE AVENUE HEALTH AND REHAB LLC
Provider Business Mailing Address
First Line : 947 S 500 E STE 105
Second Line :
City : AMERICAN FORK
State : UT
Zip : 84003-3392
Country : US
Telephone Number : 853-254-3023
Fax Number :
Provider Business Practice Location Address
First Line : 815 CENTRE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1844
Country : US
Telephone Number : 970-494-2140
Fax Number :
Authorized Official
Title or Position : CORPORATE BUSINESS DIRECTOR
Name : WENDY ANDERSON
Credential :
Telephone Number : 801-360-8804
Provider Enumeration Date : 06/30/2025
Last Update Date : 07/30/2025

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Directions to “CENTRE AVENUE HEALTH AND REHAB LLC ” Practice Location

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