Provider Demographics
NPI:1932221009
Name:WASHINGTON COUNTY NURSING HOME
Entity Type:Organization
Organization Name:WASHINGTON COUNTY NURSING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-345-2211
Mailing Address - Street 1:599 WEST GREEN HOUSE DRIVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:CO
Mailing Address - Zip Code:80720
Mailing Address - Country:US
Mailing Address - Phone:970-345-2211
Mailing Address - Fax:970-345-6963
Practice Address - Street 1:599 WEST GREEN HOUSE DRIVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:CO
Practice Address - Zip Code:80720
Practice Address - Country:US
Practice Address - Phone:970-345-2211
Practice Address - Fax:970-345-6963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1201314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05652581Medicaid
065309Medicare ID - Type Unspecified