7395 W Eastman Place Operations LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

7395 W EASTMAN PLACE OPERATIONS LLC

Doing business as

PowerBack Rehabilitation Lakewood

Practice address

7395 W Eastman PL
Lakewood, CO 80227-5006

Phone

(303) 730-8000

NPI assigned

Mar 16, 2020

Last updated

Mar 16, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

GENESIS CO HOLDINGS LLCAs reported in NPPES

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

Authorized official

Name

Michael Theodore Berg, JD

Title

VP Asst Secretary

Phone

(505) 468-4742

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PowerBack Rehabilitation Lakewood Doing business as

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1255967808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7395 W EASTMAN PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802275006",
            "telephone_number": "303-730-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7395 W EASTMAN PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802275006",
            "telephone_number": "303-730-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "7395 W EASTMAN PLACE OPERATIONS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GENESIS CO HOLDINGS LLC",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "VP ASST SECRETARY",
        "authorized_official_telephone_number": "505-468-4742",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SNF NPI",
            "identifier": "158889676",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "06540",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PowerBack Rehabilitation Lakewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Respite Care in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Respite Care in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.