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NPI Code Detail

MEDICARE: BLC - VILLAGE AT SKYLINE, LLC

MEDICARE: BLC - VILLAGE AT SKYLINE, 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
1310400000XAssisted Living Facility
2314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1003865635
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLC - VILLAGE AT SKYLINE, LLC
Provider Business Mailing Address
First Line : 2365 PATRIOT HTS
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-5122
Country : US
Telephone Number : 719-667-5360
Fax Number :
Provider Business Practice Location Address
First Line : 2365 PATRIOT HTS
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-5122
Country : US
Telephone Number : 719-667-5360
Fax Number : 719-473-9518
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : ANNA F.C. MUNOZ
Credential :
Telephone Number : 414-918-5443
Provider Enumeration Date : 05/10/2006
Last Update Date : 02/25/2025

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Directions to “BLC - VILLAGE AT SKYLINE, LLC ” Practice Location

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