NPIMap

Organization Active NPI

Volunteers of America Care Facilities

Doing business as Valley Manor Care Center

  • Skilled Nursing Facility
  • Montrose, CO
National Provider Identifier
1053332403
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1205 Issued in CO
Legal business name
VOLUNTEERS OF AMERICA CARE FACILITIES
Doing business as
Valley Manor Care Center
Practice address
1401 S Cascade Ave
Montrose, CO 81401-5003
Phone
(970) 249-9634
Fax
(970) 249-6880
NPI assigned
Jul 21, 2006
Last updated
Feb 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Authorized official

Name
Nancy Gavin
Title
Assistant Secretary/Treasurer
Phone
(952) 941-0305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1205 CO Primary

Addresses

Primary practice location

1401 S Cascade Ave
Montrose, CO 81401-5003

Mailing address

7485 Office Ridge Cir
Eden Prairie, MN 55344-3690
Phone (952) 941-0305

Other identifiers 2

IdentifierTypeStateIssuer
05655121MedicaidCO
04140729MedicaidCO

Other names 1

  • Valley Manor Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100528000134 CO Part A Provider - Skilled Nursing Facility 6103849393 Practice locations: Montrose, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053332403. Details of each certification follow.

Skilled nursing facility certification: CCN 065119

Legal name
VOLUNTEERS OF AMERICA CARE FACILITIES
Doing business as
VALLEY MANOR CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1972
Last certification
May 23, 2024
Beds
101
Ownership / control type
Church Related
Multi-facility organization
Volunteers of America National Service
Organization structure
CorporationNon-profit
Incorporated
Sep 15, 1970 in MN
Enrollment address
1401 S Cascade
Montrose, CO 81401-5003
Nursing home name
VALLEY MANOR CARE CENTER
Affiliated entity
VOLUNTEERS OF AMERICA SENIOR LIVING

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Valley Manor Care CenterCCN 065119 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Nov 1, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10166.1 residents per day on average
Chain
Volunteers of America Senior Living6 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $35,968

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Valley Manor Care Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Karen Erickson Individual Corporate DirectorDirector Jul 1, 2022
Janet Stringfellow Individual Corporate DirectorBoard Member Jul 1, 2024
Karen Hackett Individual Corporate OfficerTreasurer Jul 1, 2025
Corporate DirectorDirector Jul 1, 2023
Beth Ann Mullen Individual Corporate OfficerVice Chair Jul 1, 2025
Corporate DirectorDirector Jul 1, 2020
Michael W King Individual Corporate DirectorCeo and Chain Administrator Jul 1, 2010
Faith Ann Nutz Individual Corporate OfficerAss'T Secretary/Ass'T Treasurer Sep 1, 2018
Adp of the SNF Sep 18, 2018
Jeanne Louise Peterson Individual Corporate DirectorDirector Jul 1, 2017
Voris Vigee Individual Corporate DirectorDirector Jul 1, 2022
Debashish Chakravarty Individual Corporate OfficerAsst Treasurer/Asst Secretary Jul 1, 2025
David Nisivoccia Individual Corporate OfficerAsst Treasurer/Asst Secretary Jul 1, 2024
Organization, Madison, WI Consulting firm Adp of the SNF Jul 31, 2025
David Paskoff Individual Corporate OfficerAsst Treasurer/Asst Secretary Jul 1, 2024
Patrick N Sheridan Individual Corporate DirectorDirector Jul 1, 2023
Shawn Bloom Individual Corporate DirectorDirector Mar 23, 2010
Dejernette Beaty Individual Corporate OfficerAsst Treasurer/Asst Secretary Jul 1, 2025
Paul Soczynski Individual Operational/Managerial Control Jan 20, 2025
Adp of the SNF Jan 20, 2025
Derrick N Perkins Individual Corporate OfficerChairperson Jul 1, 2024
Corporate DirectorDirector Jul 1, 2019
Carmen Jackson Individual Corporate DirectorBoard Member Jul 1, 2025
Rebecca Walker Individual Operational/Managerial Control Jun 3, 2024
Adp of the SNF Jun 3, 2024
Xiao Song Individual Operational/Managerial Control Jul 1, 2024
Adp of the SNF Jan 31, 2025
Volunteers of America National Services Organization, Eden Prairie, MN Non-profit 5% Or Greater Direct Ownership Interest Mar 9, 1982 100%
Operational/Managerial Control Dec 1, 1985
Adp of the SNF Dec 3, 2025
Joseph Anthony Budzynski Individual Corporate OfficerAss'T Secretary/Ass'T Treasurer Apr 2, 2012
Organization, Madison, WI Consulting firm Adp of the SNF Jul 31, 2025

Owners & managing parties with NPI records 1

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

  • Xiao Song, MD
    • Internal Medicine Physician
    • Denver, CO
    • NPI 1699392449

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rochester Rehabilitation and Living CenterRochester, MN, CCN 245626 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Feb 19, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1053332403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7485 OFFICE RIDGE CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443690",
            "telephone_number": "952-941-0305",
            "fax_number": "952-941-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S CASCADE AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015003",
            "telephone_number": "970-249-9634",
            "fax_number": "970-249-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOLUNTEERS OF AMERICA CARE FACILITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY/TREASURER",
        "authorized_official_telephone_number": "952-941-0305"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05655121",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04140729",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Manor Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Manor Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montrose, CO

Sources for this page

Verify at the official NPI Registry.