Provider Demographics
NPI:1639712029
Name:MEADOWBROOK BLVD. OPERATIONS, LLC
Entity Type:Organization
Organization Name:MEADOWBROOK BLVD. OPERATIONS, LLC
Other - Org Name:PAONIA CARE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF AR
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-661-0764
Mailing Address - Street 1:26522 LA ALAMEDA STE 300
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8302
Mailing Address - Country:US
Mailing Address - Phone:949-449-2500
Mailing Address - Fax:
Practice Address - Street 1:1625 MEADOWBROOK BLVD
Practice Address - Street 2:
Practice Address - City:PAONIA
Practice Address - State:CO
Practice Address - Zip Code:81428-9325
Practice Address - Country:US
Practice Address - Phone:970-527-4837
Practice Address - Fax:970-527-6407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care