NPIMap

Organization Active NPI

Creekside Gardens Assisted Living Facility LLC

  • Respite Care
  • Fort Collins, CO
National Provider Identifier
1215605886
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
Legal business name
CREEKSIDE GARDENS ASSISTED LIVING FACILITY LLC
Doing business as
Creekside Gardens Assisted Living Facility
Practice address
1000 E Stuart St
Fort Collins, CO 80525-1555
Phone
(970) 494-3253
NPI assigned
Aug 31, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Authorized official

Name
Ely Bloch
Title
Legal Assistant
Phone
(718) 942-3483

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X Primary

Addresses

Primary practice location

1000 E Stuart St
Fort Collins, CO 80525-1555

Mailing address

2420 Knapp St
Brooklyn, NY 11235-1006
Phone (718) 942-3483

Other names 1

  • Creekside Gardens Assisted Living Facility Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL pcc Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Creekside Gardens Assisted Living Facility2 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.

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1215605886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 KNAPP ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112351006",
            "telephone_number": "718-942-3483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E STUART ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805251555",
            "telephone_number": "970-494-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE GARDENS ASSISTED LIVING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "BLOCH",
        "authorized_official_first_name": "ELY",
        "authorized_official_title_or_position": "LEGAL ASSISTANT",
        "authorized_official_telephone_number": "718-942-3483"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pcc",
            "affiliation": "N",
            "endpointDescription": "medical records",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1000 E Stuart St",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805251555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Creekside Gardens Assisted Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.