Healthcare Provider Details

I. General information

NPI: 1144129131
Provider Name (Legal Business Name): DELTA SC OPS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2026
Last Update Date: 11/04/2026
Certification Date: 11/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 ASPEN WAY
DELTA CO
81416-2551
US

IV. Provider business mailing address

1380 ASPEN WAY
DELTA CO
81416-2551
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-1421
  • Fax: 970-874-8018
Mailing address:
  • Phone: 970-874-1421
  • Fax: 970-874-8018

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: 303-378-8320