Pine Ridge Extended Care Center, LLC
NPI #1336206010 in Pagosa Springs, Colorado
Provider Information
- NPI Number
- 1336206010
- Entity Type
- Organization
- Organization Name
- Pine Ridge Extended Care Center, LLC
- Primary Specialty
- Respite Care
- Enumeration Date
- Jan 2, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 119 BASTILLE DR
- City
- Pagosa Springs
- State
- Colorado
- ZIP Code
- 81147-9388
- Phone
- (970) 731-4330
Authorized Official
- Name
- MARY BROOKS
- Title
- ADMINISTRATOR
- Phone
- (970) 731-4330
Specialties & Taxonomy Codes
| Specialty |
|---|
| Respite Care |
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