MEDICARE: BKD SKYLINE PROPCO, 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

General Provider Information

NPI Number	:	1861340671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BKD SKYLINE PROPCO, LLC

Provider Business Mailing Address
First Line	:	2305 PATRIOT HTS
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-5105
Country	:	US
Telephone Number	:	719-667-5360
Fax Number	:

Provider Business Practice Location Address
First Line	:	2305 PATRIOT HTS
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-5105
Country	:	US
Telephone Number	:	719-667-5360
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	ANNA F.C. MUNOZ
Credential	:
Telephone Number	:	414-918-5443

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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