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NPI Code Detail

MEDICARE: SEQUOIA CARE COMMUNITY, LLC

MEDICARE: SEQUOIA CARE COMMUNITY, 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
1314000000XSkilled Nursing Facility
2314000000XSkilled Nursing Facility0291CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457362790
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEQUOIA CARE COMMUNITY, LLC
Provider Business Mailing Address
First Line : 12136 W BAYAUD AVE STE 200
Second Line :
City : LAKEWOOD
State : CO
Zip : 80228-2115
Country : US
Telephone Number : 303-987-3088
Fax Number : 303-987-0434
Provider Business Practice Location Address
First Line : 6060 E. ILIFF AVENUE
Second Line :
City : DENVER
State : CO
Zip : 80222-5721
Country : US
Telephone Number : 303-759-4221
Fax Number : 303-759-4005
Authorized Official
Title or Position : DIRECTOR OF REIMBURSEMENT
Name : MS. MARY KORETKE
Credential :
Telephone Number : 720-974-6278
Provider Enumeration Date : 08/11/2006
Last Update Date : 02/05/2010

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Directions to “SEQUOIA CARE COMMUNITY, LLC ” Practice Location

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