Active NPI
BLC - Village at Skyline, LLC
- Skilled Nursing Facility
- Colorado Springs, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
- Brookdale Skyline-ALR
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 Skyline
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare
- Ownership
- For profit - Corporation
- Certified
- Nov 26, 2003
- Medicare certification status
- Active
- Certified beds
- 82
- Chain
- Brookdale Senior Living
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D1018434 | Village at Skyline | Certificate of waiver | Oct 21, 2027 |
National Provider Directory
National Provider DirectoryNetworks
- 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Mark Fioravanti | Adp of the SNF | Apr 13, 2025 | |
| Adp of the SNF | Jul 22, 2025 | ||
| Claudia Drayton | Adp of the SNF | Jun 18, 2024 | |
| Brookdale Living Communities, Inc | Adp of the SNF | Dec 20, 2016 | |
| Indirect Ownership Interest | Mar 30, 2005 | 100% | |
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Prudential Financial | Adp of the SNF | Sep 24, 2025 | |
| Kevin W la Marre | Operational/Managerial Control | Jan 22, 2017 | |
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Brookdale Senior Living Inc | Adp of the SNF | Dec 20, 2016 | |
| Indirect Ownership Interest | Jun 28, 2008 | 100% | |
| Brookdale F&B, LLC | Indirect Ownership Interest | Mar 30, 2025 | 100% |
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Matthew Whitley | Operational/Managerial Control | Jun 12, 2025 | |
| Adp of the SNF | Jul 3, 2025 | ||
| Anneliese Muhlbauer | Operational/Managerial Control | Jul 22, 2025 | |
| Adp of the SNF | Sep 24, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Chadwick C White | Operational/Managerial Control | Mar 9, 2018 | |
| Managing Control - Governing Body | Mar 9, 2018 | ||
| Indirect Ownership Interest | Apr 3, 2025 | 0.13% | |
| Elizabeth Mace | Adp of the SNF | Jun 18, 2024 | |
| Adp of the SNF | Sep 24, 2025 | ||
| Lee Wielansky | Adp of the SNF | Apr 23, 2015 | |
| Thomas a Smith | Corporate Director | Apr 30, 2007 | |
| Denise W Warren | Adp of the SNF | Oct 4, 2018 | |
| Jordan R Asher | Adp of the SNF | Feb 24, 2020 | |
| Prudential Multifamily Mortgage LLC | 5% Or Greater Mortgage Interest | Dec 20, 2016 | 100% |
| 5% Or Greater Security Interest | Dec 20, 2016 | 100% | |
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| LBMC PC | Adp of the SNF | Jan 1, 2024 | |
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Anna F.C. Munoz | Operational/Managerial Control | Apr 5, 2024 | |
| Nikolas W Stengle | Operational/Managerial Control | Nov 8, 2025 | |
| Adp of the SNF | Jul 22, 2025 | ||
| Vikas Thouti Reddy | Operational/Managerial Control | Jul 22, 2025 | |
| Adp of the SNF | Sep 24, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jun 1, 2003 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| BKD Skyline Proco LLC | Adp of the SNF | Dec 20, 2016 | |
| Adp of the SNF | Jul 22, 2025 | ||
| BLC Management - 3, LLC | Direct Ownership Interest | Mar 30, 2005 | 100% |
| Adp of the SNF | Jul 22, 2025 | ||
| Victoria Freed | Adp of the SNF | Oct 29, 2019 | |
| Dawn Kussow | Operational/Managerial Control | Apr 30, 2025 | |
| Indirect Ownership Interest | Apr 30, 2025 | 0.05% | |
| BKD FM7 Holdco Mi-Co LLC | Adp of the SNF | Dec 20, 2016 | |
| Joshua Hausman | Adp of the SNF | Apr 24, 2025 | |
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Walters Financial Services Inc | Adp of the SNF | Jul 22, 2025 | |
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| Adp of the SNF | Jul 22, 2025 | ||
| 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.
-
- Family Medicine Physician
- Parker, CO
- NPI 1295099596
Adp of the SNF, Operational/Managerial Control
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.