Provider Demographics
NPI:1881726891
Name:RED ROCKS CENTER FOR REHABILITATION
Entity type:Organization
Organization Name:RED ROCKS CENTER FOR REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:JOINT PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KESTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-277-0700
Mailing Address - Street 1:755 HERITAGE RD
Mailing Address - Street 2:SUTIE 100
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3600
Mailing Address - Country:US
Mailing Address - Phone:303-277-0700
Mailing Address - Fax:303-277-0714
Practice Address - Street 1:755 HERITAGE RD
Practice Address - Street 2:SUTIE 100
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3600
Practice Address - Country:US
Practice Address - Phone:303-277-0700
Practice Address - Fax:303-277-0714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO72276266Medicaid
COC381908Medicare ID - Type Unspecified