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NPI Code Detail

MEDICARE: REGENT PARK CARE CENTER LLC

MEDICARE: REGENT PARK CARE CENTER 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

General Provider Information

NPI Number : 1972356996
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGENT PARK CARE CENTER LLC
Provider Business Mailing Address
First Line : 720 S COLORADO BLVD STE 211
Second Line :
City : GLENDALE
State : CO
Zip : 80246-1904
Country : US
Telephone Number : 720-974-6278
Fax Number :
Provider Business Practice Location Address
First Line : 816 S INTEROCEAN AVE
Second Line :
City : HOLYOKE
State : CO
Zip : 80734-2120
Country : US
Telephone Number : 970-854-2251
Fax Number : 970-854-2610
Authorized Official
Title or Position : DIRECTOR COST REPORTING
Name : MARY KORETKE
Credential :
Telephone Number : 303-378-8320
Provider Enumeration Date : 04/09/2024
Last Update Date : 04/09/2024

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Directions to “REGENT PARK CARE CENTER LLC ” Practice Location

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