Provider Demographics
NPI:1669844759
Name:POINT OF THE PINES GARDENS LLC
Entity type:Organization
Organization Name:POINT OF THE PINES GARDENS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:TRIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-542-2223
Mailing Address - Street 1:330 ELKTON DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8511
Mailing Address - Country:US
Mailing Address - Phone:719-265-0030
Mailing Address - Fax:719-260-5518
Practice Address - Street 1:330 ELKTON DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8511
Practice Address - Country:US
Practice Address - Phone:719-265-0030
Practice Address - Fax:719-260-5518
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POINT OF THE PINES GARDENS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-28
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23B948310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO88724875Medicaid