Organization Active NPI

BLC - Village at Skyline, LLC

  • Skilled Nursing Facility
  • Colorado Springs, CO
National Provider Identifier
1003865635
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BLC - VILLAGE AT SKYLINE, LLC
Practice address
2365 Patriot HTS
Colorado Springs, CO 80904-5122
Phone
(719) 667-5360
Fax
(719) 473-9518
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anna F.C. Munoz
Title
Assistant Secretary
Phone
(414) 918-5443

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2365 Patriot HTS
Colorado Springs, CO 80904-5122

Mailing address

2365 Patriot HTS
Colorado Springs, CO 80904-5122
Phone (719) 667-5360

Other names 2

  • Brookdale Skyline Doing business as
  • Brookdale Skyline-ALR Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050330000136 CO Part A Provider - Skilled Nursing Facility 7911953286 Practice locations: Colorado Springs, CO

Skilled nursing facility certification: CCN 065382

Legal name
BLC - VILLAGE AT SKYLINE LLC
Doing business as
BROOKDALE SKYLINE
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Nov 26, 2003
Last certification
Apr 17, 2025
Beds
82
Ownership / control type
Corporation
Multi-facility organization
Brookdale Senior Living
Most recent change of ownership
Apr 6, 2005
Organization structure
LLCProprietary
Enrollment address
2365 Patriot Heights
Colorado Springs, CO 80904-5135
Nursing home name
BROOKDALE SKYLINE
Affiliated entity
BROOKDALE SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Brookdale SkylineCCN 065382
Overall star rating
5 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
For profit - Corporation
Certified
Nov 26, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8244.9 residents per day on average
Chain
Brookdale Senior Living12 facilities in the chain
Penalties (3 years)
1Fines totaling $9,110

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D1018434Village at Skyline2365 Patriot Heights, Colorado Springs, CO 80904Certificate of waiverOct 21, 2027

National Provider Directory

National Provider Directory

Networks

  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a

Ownership & related parties

All disclosed owners & managing parties 66

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Mark Fioravanti Individual Adp of the SNF Apr 13, 2025
Individual Adp of the SNF Jul 22, 2025
Claudia Drayton Individual Adp of the SNF Jun 18, 2024
Brookdale Living Communities, Inc Organization, Brentwood, TN Corporation Adp of the SNF Dec 20, 2016
Indirect Ownership Interest Mar 30, 2005 100%
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Prudential Financial Organization, Newark, NJ Corporation, Financial institution Adp of the SNF Sep 24, 2025
Kevin W la Marre Individual Operational/Managerial Control Jan 22, 2017
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Brookdale Senior Living Inc Organization, Brentwood, TN Corporation, Holding company, Chain home office Adp of the SNF Dec 20, 2016
Indirect Ownership Interest Jun 28, 2008 100%
Brookdale F&B, LLC Organization, Brentwood, TN LLC, Owned by another organization or individual Indirect Ownership Interest Mar 30, 2025 100%
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Matthew Whitley Individual Operational/Managerial Control Jun 12, 2025
Adp of the SNF Jul 3, 2025
Anneliese Muhlbauer Individual Operational/Managerial Control Jul 22, 2025
Adp of the SNF Sep 24, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Chadwick C White Individual Operational/Managerial Control Mar 9, 2018
Managing Control - Governing BodyExe Vice President & Secretary/M Mar 9, 2018
Indirect Ownership Interest Apr 3, 2025 0.13%
Elizabeth Mace Individual Adp of the SNF Jun 18, 2024
Organization, Newark, NJ Corporation, Financial institution Adp of the SNF Sep 24, 2025
Lee Wielansky Individual Adp of the SNF Apr 23, 2015
Thomas a Smith Individual Corporate Director Apr 30, 2007
Denise W Warren Individual Adp of the SNF Oct 4, 2018
Jordan R Asher Individual Adp of the SNF Feb 24, 2020
Prudential Multifamily Mortgage LLC Organization, Wilmington, DE LLC, Financial institution, Owned by another organization or individual 5% Or Greater Mortgage Interest Dec 20, 2016 100%
5% Or Greater Security Interest Dec 20, 2016 100%
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
LBMC PC Organization, Brentwood, TN Corporation Adp of the SNF Jan 1, 2024
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Anna F.C. Munoz Individual Operational/Managerial Control Apr 5, 2024
Nikolas W Stengle Individual Operational/Managerial Control Nov 8, 2025
Individual Adp of the SNF Jul 22, 2025
Vikas Thouti Reddy Individual Operational/Managerial Control Jul 22, 2025
Adp of the SNF Sep 24, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jun 1, 2003
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
BKD Skyline Proco LLC Organization, Brentwood, TN LLC Adp of the SNF Dec 20, 2016
Individual Adp of the SNF Jul 22, 2025
BLC Management - 3, LLC Organization, Brentwood, TN LLC, Owned by another organization or individual Direct Ownership Interest Mar 30, 2005 100%
Individual Adp of the SNF Jul 22, 2025
Victoria Freed Individual Adp of the SNF Oct 29, 2019
Dawn Kussow Individual Operational/Managerial Control Apr 30, 2025
Indirect Ownership Interest Apr 30, 2025 0.05%
BKD FM7 Holdco Mi-Co LLC Organization, Brentwood, TN LLC Adp of the SNF Dec 20, 2016
Joshua Hausman Individual Adp of the SNF Apr 24, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Walters Financial Services Inc Organization, Sarasota, FL Corporation, Consulting firm Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025
Individual Adp of the SNF Jul 22, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1003865635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 PATRIOT HTS",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809045122",
            "telephone_number": "719-667-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 PATRIOT HTS",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809045122",
            "telephone_number": "719-667-5360",
            "fax_number": "719-473-9518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLC - VILLAGE AT SKYLINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "MUNOZ",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "F.C.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "414-918-5443"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Skyline",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookdale Skyline-ALR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.