Fairacres Manor, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0576 Issued in CO

Legal business name

FAIRACRES MANOR, INC

Practice address

1700 18TH Ave
Greeley, CO 80631-5134

Phone

(970) 353-3370

Fax

(970) 353-9347

NPI assigned

Jan 11, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Mary Koretke

Title

Director of Reimbursement

Phone

(720) 974-6278

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fairacres Manor Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Skilled nursing facility certification: CCN 065211

Legal name

FAIRACRES MANOR, INC

Doing business as

FAIRACRES MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 1, 1985

Last certification

Jun 6, 2024

Beds

116

Ownership / control type

Limited Liability Corporation

Organization structure

CorporationProprietary

Incorporated

May 3, 1965 in CO

Enrollment address

1700 18TH Ave
Fairacres Manor
Greeley, CO 80631-5134

Nursing home name

FAIRACRES MANOR, INC.

Affiliated entity

FRONTLINE MANAGEMENT

Listed as

Fairacres Manor, Inc.CCN 065211

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Aug 1, 1985

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

116106.4 residents per day on average

Chain

Frontline Management9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Fairacres Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fairacres Manor, Inc

  • Skilled Nursing Facility
  • Greeley, CO
  • NPI 1205209764
  NPD tax ID

All disclosed owners & managing parties 32

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

Facilities with the same owner 8

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

• 1111 Bonforte Opco, LLC

  • Skilled Nursing Facility
  • Pueblo, CO
  • NPI 1285060756

  Frontier Management Inc

  CMS ownership
• Heights Healthcare Company LLC

  • Skilled Nursing Facility
  • Longmont, CO
  • NPI 1699755660

  Frontier Management Inc

  CMS ownership
• Madison Senior Living Management LLC

  • Skilled Nursing Facility
  • Burlington, CO
  • NPI 1790123669

  Frontier Management Inc

  CMS ownership
• Red Canyon Village LLC

  • Skilled Nursing Facility
  • Canon City, CO
  • NPI 1689248882

  Frontier Management Inc

  CMS ownership
• Garden Valley Retirement Village, LLC

  • Skilled Nursing Facility
  • Garden City, KS
  • NPI 1710210943

  Frontier Management Inc

  CMS ownership
• Liberal SNF Op Co LLC

  • Skilled Nursing Facility
  • Liberal, KS
  • NPI 1013309830

  Frontier Management Inc

  CMS ownership
• Trinity Manor Opco LLC

  • Skilled Nursing Facility
  • Dodge City, KS
  • NPI 1497019749

  Frontier Management Inc

  CMS ownership
• Winfield LTC Opco LLC

  • Skilled Nursing Facility
  • Winfield, KS
  • NPI 1437550522

  Frontier Management Inc

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Romano Nteela Abuaba, MD

  • Internal Medicine Physician
  • Aurora, CO
  • NPI 1295014710
  NPD (past)
• Tamara L McCue, D.O.

  • Family Medicine Physician
  • Wellington, KS
  • NPI 1457339137
  NPD (past)

Affiliated clinicians 2

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

• Romano Nteela Abuaba, MD

  • Internal Medicine Physician
  • Aurora, CO
  • NPI 1295014710

  Nursing home

  Care Compare affiliation
• David B Smith, MD

  • Family Medicine Physician
  • Greeley, CO
  • NPI 1962491969

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265328000000",
    "number": "1154300853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12136 W BAYAUD AVENUE",
            "address_2": "SUITE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282115",
            "telephone_number": "303-987-3088",
            "fax_number": "303-987-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 18TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315134",
            "telephone_number": "970-353-3370",
            "fax_number": "970-353-9347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRACRES MANOR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2010-02-05",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "720-974-6278",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "0576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05653423",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairacres Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chuk-Davis Obinna Ezeli
• Face Down Medical Equipment, LLC
• Kathleen Rose Fahey, PH.D., CCC-ALP
• Herbert Daniel Fahrenholtz, MD
• Elise S Fair, MA, LPC
• Fairacres Manor, Inc
• Sandra L Fairbanks, MA
• Brittany Fairchild, BSW
• Family Dental and Specialists of Greeley
• Family Physicians of Greeley

• Skilled Nursing Facility in Greeley, CO
• Providers in Greeley, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.

Verify at the official NPI Registry.