Healthcare Provider Details

I. General information

NPI: 1295688687
Provider Name (Legal Business Name): VALLEY VIEW CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 N 10TH ST
CANON CITY CO
81212-2211
US

IV. Provider business mailing address

2120 N 10TH ST
CANON CITY CO
81212-2211
US

V. Phone/Fax

Practice location:
  • Phone: 719-275-7569
  • Fax: 719-275-3890
Mailing address:
  • Phone: 719-275-7569
  • Fax: 719-275-3890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MARY KORETKE
Title or Position: DIRECTOR COST REPORTING
Credential:
Phone: 720-974-6278