Healthcare Provider Details

I. General information

NPI: 1700769841
Provider Name (Legal Business Name): CANYON VIEW CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 E 3RD ST
PALISADE CO
81526-5006
US

IV. Provider business mailing address

151 E 3RD ST
PALISADE CO
81526-5006
US

V. Phone/Fax

Practice location:
  • Phone: 970-464-7500
  • Fax: 970-464-0815
Mailing address:
  • Phone: 970-464-7500
  • Fax: 970-464-0815

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