MEDICARE: VI/RA AURORA VILLAGES, 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	310400000X	Assisted Living Facility	AL-0928	CO
2	314000000X	Skilled Nursing Facility	1215	CO

General Provider Information

NPI Number	:	1447345939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VI/RA AURORA VILLAGES, LLC

Provider Business Mailing Address
First Line	:	2670 S. ABILENE STREET WEST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-2337
Country	:	US
Telephone Number	:	303-695-8100
Fax Number	:	303-695-8101

Provider Business Practice Location Address
First Line	:	2670 S. ABILENE STREET WEST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-2337
Country	:	US
Telephone Number	:	303-695-8100
Fax Number	:	303-695-8101

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. ANN KOKISH
Credential	:
Telephone Number	:	303-695-8100

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	03/10/2011

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