Provider Demographics
NPI:1386188746
Name:CENTER AT PARKVIEW, LLC
Entity Type:Organization
Organization Name:CENTER AT PARKVIEW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:ESMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-877-8517
Mailing Address - Street 1:400 W 16TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2745
Mailing Address - Country:US
Mailing Address - Phone:719-584-4790
Mailing Address - Fax:719-584-4031
Practice Address - Street 1:400 W 16TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2745
Practice Address - Country:US
Practice Address - Phone:719-584-4790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility