MEDICARE: COLUMBINE WEST HEALTH AND REHAB 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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1073402269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBINE WEST HEALTH AND REHAB LLC

Provider Business Mailing Address
First Line	:	947 S 500 E STE 105
Second Line	:
City	:	AMERICAN FORK
State	:	UT
Zip	:	84003-3392
Country	:	US
Telephone Number	:	853-254-3023
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 WORTHINGTON CIR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-1840
Country	:	US
Telephone Number	:	907-221-2273
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE BUSINESS DIRECTOR
Name	:	WENDY ANDERSON
Credential	:
Telephone Number	:	801-360-8804

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	08/27/2025

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