Colton River Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COLTON RIVER HEALTHCARE LLC

Practice address

721 S Highway 78
Wylie, TX 75098-4004

Phone

(972) 303-8100

Fax

(972) 303-8101

NPI assigned

Dec 11, 2025

Organization subpart

No

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

Authorized official

Name

Soon Burnam

Title

Secretary

Phone

(949) 540-1249

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1765411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765411200000",
    "number": "1154285443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 S HIGHWAY 78",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984004",
            "telephone_number": "972-303-8100",
            "fax_number": "972-303-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 S HIGHWAY 78",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984004",
            "telephone_number": "972-303-8100",
            "fax_number": "972-303-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLTON RIVER HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-11",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.