Healthcare Provider Details

I. General information

NPI: 1184371908
Provider Name (Legal Business Name): FRONT RANGE HEALTH & REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2022
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 E ELIZABETH ST
FORT COLLINS CO
80524-3911
US

IV. Provider business mailing address

1005 E ELIZABETH ST
FORT COLLINS CO
80524-3911
US

V. Phone/Fax

Practice location:
  • Phone: 970-482-2525
  • Fax:
Mailing address:
  • Phone: 970-482-2525
  • Fax:

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: EPHRAM MORDY LAHASKY
Title or Position: SOLE MEMBER
Credential:
Phone: 646-772-3668