EBEN EZER LUTHERAN CARE CENTER (NPI# 1477175172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477175172 |
| Entity Type | Organization |
| Organization Name | EBEN EZER LUTHERAN CARE CENTER |
| Practice Address |
1910 Edison St Brush CO 80723-1743 |
| Mailing Address |
122 Hospital Rd Brush CO 80723-1702 |
| Practice Telephone | 9708422861 |
| Mailing Telephone | 9708422861 |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-05-15 |
| Authorized Official Name | LESLIE MASON (CFO) |
| Authorized Official Telephone | 9708422861 |
| Is Organization Subpart | Y |
| Parent Organization Name | EBEN EZER LUTHERAN CARE CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 04070330 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407852981 | Eben Ezer Lutheran Care Center | Skilled Nursing Facility | 122 Hospital Rd, Brush, CO 80723-1702 | 2005-06-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EBEN EZER LUTHERAN CARE CENTER | 122 Hospital Rd, Brush, CO 80723-1702 |
| Street Address |
1910 EDISON ST |
| City | BRUSH |
| State | CO |
| Zip Code | 80723-1743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366543639 | Therese A Gonzales | Dental Hygienist | 412 Edison, Brush, CO 80723 | 2006-09-26 |
| 1821056375 | Suzanne R Becker | Social Worker | 518 Curtis St, Brush, CO 80723 | 2006-05-03 |
| 1740242494 | Morgan County Dental Care PC | Dentist | 242 Cambridge St, Brush, CO 80723 | 2006-04-06 |
| 1598170532 | Landon Heckman | Dentist | 242 Cambridge St, Brush, CO 80723 | 2014-06-28 |
| 1861946832 | Colorado Dentistry for Children LLC | Dentist | 242 Cambridge St, Brush, CO 80723-1608 | 2016-08-08 |
| 1609219757 | Carissa Molina | Dentist | 242 Cambridge St, Brush, CO 80723-1608 | 2013-04-09 |
| 1275734584 | Monty Carl Kingsley | Dentist | 242 Cambridge St, Suite 2, Brush, CO 80723-1608 | 2007-05-31 |
| 1841310737 | Ssc Brush Sunset Manor Operating Company LLC | Respite Care | 2200 Edison St, Brush, CO 80723-1609 | 2007-04-02 |
| 1548819147 | Juhee Yi | Speech-Language Pathologist | 2200 Edison St, Brush, CO 80723-1609 | 2019-09-05 |
| 1194374009 | Lodina Marlene Weingardt | Physical Therapy Assistant | 2200 Edison St, Brush, CO 80723-1609 | 2019-09-04 |
| Find all providers in zip 80723 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881294825 | Tcal2 | Assisted Living Facility | 1069 S Teller St, Lakewood, CO 80226-4554 | 2020-10-29 |
| 1336749373 | Tcal2 | Assisted Living Facility | 6419 W Mexico Ave, Lakewood, CO 80232-7055 | 2020-10-29 |
| 1316553068 | Lower Valley Hospital Association | Assisted Living Facility | 243 N Cherry St, Fruita, CO 81521-2102 | 2020-09-18 |
| 1003427311 | Easley Senior Care LLC | Assisted Living Facility | 17351 W 64th Ave, Arvada, CO 80007-7796 | 2020-08-11 |
| 1528676111 | Pine Ridge Terrace Manor LLC | Assisted Living Facility | 378 S Pearl St, Elizabeth, CO 80107-7519 | 2020-07-20 |
| 1669090965 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 2240 Pratt St, Longmont, CO 80501-1497 | 2020-07-13 |
| 1699393728 | Planet View Inc. | Assisted Living Facility | 6994 County Road 39, Fort Lupton, CO 80621-8528 | 2020-07-06 |
| 1093339665 | Graceful Hearts Assisted Living | Assisted Living Facility | 6780 E Lake Cir, Centennial, CO 80111-4410 | 2020-05-30 |
| 1912520925 | Apex Assisted Living LLC | Assisted Living Facility | 3071 S Rosemary St, Denver, CO 80231-4186 | 2020-05-26 |
| 1104447978 | Northern Colorado Living Solutions | Assisted Living Facility | 4021 Spruce Dr, Fort Collins, CO 80526-1059 | 2020-05-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.