NPIMap

Organization Active NPI

Centre Avenue Health & Rehab Facility LLC

  • Skilled Nursing Facility
  • Fort Collins, CO
National Provider Identifier
1194719872
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0434 Issued in CO
Legal business name
CENTRE AVENUE HEALTH & REHAB FACILITY LLC
Practice address
815 Centre Ave
Fort Collins, CO 80526-1844
Phone
(970) 494-2140
Fax
(970) 494-2141
NPI assigned
Sep 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Authorized official

Name
Mr. Barry Kent Fancher
Title
Cfo
Phone
(970) 482-0198

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0434 CO Primary

Addresses

Primary practice location

815 Centre Ave
Fort Collins, CO 80526-1844

Mailing address

815 Centre Ave
Fort Collins, CO 80526-1844
Phone (970) 494-2140

Other names 1

  • Centre Avenue Health & Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100202000946 CO Part A Provider - Skilled Nursing Facility 3779559026 Practice locations: Fort Collins, CO

Skilled nursing facility certification: CCN 065377

Legal name
CENTRE AVENUE HEALTH & REHAB FACILITY LLC
Doing business as
CENTRE AVENUE HEALTH & REHAB FACILITY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 10, 2001
Last certification
Oct 3, 2024
Beds
90
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Columbine Health Systems
Most recent change of ownership
Dec 1, 2025
Organization structure
LLCProprietary
Incorporated
Jul 27, 2000 in CO
Enrollment address
815 Centre Ave
Centre Avenue Health & Rehab Facility
Fort Collins, CO 80526-1844
Nursing home name
CENTRE AVENUE HEALTH AND REHAB LLC

Care Compare: Nursing home

Medicare Care Compare
Listed as
Centre Avenue Health and Rehab LLCCCN 065377
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 10, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9093.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

815 Centre Ave
Fort Collins, CO 80526
Phone (970) 472-8700

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
John Robert Wilson Individual 5% Or Greater Direct Ownership Interest Dec 6, 1971 50%
Corporate Director Dec 6, 1971 100%
W-2 Managing Employee Dec 6, 1971 100%
Lauren J Fasciano-Sager Individual Corporate OfficerSecretary Nov 21, 2012
W-2 Managing Employee Nov 21, 2012
Barry Kent Fancher Individual Corporate Officer Jul 1, 1999 100%
W-2 Managing Employee Jul 1, 1999 100%
Columbine Management Services Inc Organization, Fort Collins, CO Operational/Managerial Control Sep 26, 2000

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational 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": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1194719872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 CENTRE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261844",
            "telephone_number": "970-494-2140",
            "fax_number": "970-494-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 CENTRE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805261844",
            "telephone_number": "970-494-2140",
            "fax_number": "970-494-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRE AVENUE HEALTH & REHAB FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "FANCHER",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "970-482-0198",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "0434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centre Avenue Health & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.