Provider Demographics
NPI:1225159072
Name:LEXICON CARE, INC.
Entity Type:Organization
Organization Name:LEXICON CARE, INC.
Other - Org Name:DBA SUMMIT REHABILIATION AND CARE COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KORETKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-987-3088
Mailing Address - Street 1:500 GENEVA STREET
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-4305
Mailing Address - Country:US
Mailing Address - Phone:303-987-3088
Mailing Address - Fax:
Practice Address - Street 1:500 GENEVA STREET
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-4305
Practice Address - Country:US
Practice Address - Phone:303-364-9311
Practice Address - Fax:303-367-4639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO020407314000000X
CO0876385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO58606882Medicaid
CO58606882Medicaid