Trinity Life Gardens

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2306B3 Issued in CO

Legal business name

TRINITY LIFE GARDENS

Practice address

2430 Oakshire LN
Pueblo, CO 81001-5655

Phone

(719) 542-2223

Fax

(719) 586-9256

NPI assigned

Oct 19, 2015

Last updated

Oct 19, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kriss Prado, RN

Title

Executive Director

Phone

(719) 406-5288

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1033580808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 OAKSHIRE LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810015655",
            "telephone_number": "719-542-2223",
            "fax_number": "719-586-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 OAKSHIRE LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810015655",
            "telephone_number": "719-542-2223",
            "fax_number": "719-586-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY LIFE GARDENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "PRADO",
        "authorized_official_first_name": "KRISS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-406-5288",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "2306B3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79232051",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.