Pine Ridge Extend Care Center, LLC
NPI #1245237494 in Pagosa Springs, Colorado
Provider Information
- NPI Number
- 1245237494
- Entity Type
- Organization
- Organization Name
- Pine Ridge Extend Care Center, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jul 1, 2005
- Last Updated
- Oct 6, 2015
Practice Location
- Address
- 119 BASTILLE DR
- City
- Pagosa Springs
- State
- Colorado
- ZIP Code
- 81147-9388
- Phone
- (970) 731-4330
Authorized Official
- Name
- MARY J. BROOKS, RN
- Title
- NURSING HOME ADMINISTRATOR
- Phone
- (970) 731-4330
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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