Provider Demographics
NPI:1275386252
Name:ALLISON CARE CENTER LLC
Entity Type:Organization
Organization Name:ALLISON CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR COST REPORTING
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:303-378-8320
Mailing Address - Street 1:720 S COLORADO BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1904
Mailing Address - Country:US
Mailing Address - Phone:720-974-6278
Mailing Address - Fax:303-987-0434
Practice Address - Street 1:1660 ALLISON ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-6023
Practice Address - Country:US
Practice Address - Phone:303-232-7177
Practice Address - Fax:303-232-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility