Organization Active NPI

Allison Care Center LLC

  • Skilled Nursing Facility
  • Lakewood, CO
National Provider Identifier
1275386252
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ALLISON CARE CENTER LLC
Doing business as
Allison Care Center
Practice address
1660 Allison St
Lakewood, CO 80214-6023
Phone
(303) 232-7177
Fax
(303) 232-0122
NPI assigned
Apr 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Mary Koretke
Title
Director Cost Reporting
Phone
(303) 378-8320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1660 Allison St
Lakewood, CO 80214-6023

Mailing address

1660 Allison St
Lakewood, CO 80214-6023
Phone (303) 232-7177

Other names 1

  • Allison Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250428004137 TX Part A Provider - Skilled Nursing Facility 7517483035 Practice locations: Lakewood, CO

Skilled nursing facility certification: CCN 065297

Legal name
ALLISON CARE CENTER LLC
Doing business as
ALLISON CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1991
Last certification
Mar 13, 2025
Beds
85
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Vivage Beecan Senior
Most recent change of ownership
Jul 1, 2024
Organization structure
LLCProprietary
Enrollment address
1660 Allison St
Lakewood, CO 80214-6023
Nursing home name
ALLISON CARE CENTER
Affiliated entity
LONG PEAK OPERATING COMPANY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Allison Care CenterCCN 065297 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Dec 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8577.7 residents per day on average
Chain
Long Peak Operating Company8 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
2Fines totaling $34,580

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Allison Care Center2 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.

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Allison SNF Holding LLC Organization, Sacramento, CA Created for acquisition, LLC, Holding company 5% Or Greater Direct Ownership Interest Jul 1, 2024 99.99%
Savanah Stark Individual Operational/Managerial Control Jul 1, 2024
Adp of the SNF Aug 6, 2020
Karla Valle Individual Corporate OfficerChief Operating Officer Jul 1, 2024 100%
Adp of the SNF Jul 1, 2024
Mary E Koretke Individual Corporate OfficerDirector Cost Reporting Jul 1, 2024 100%
Adp of the SNF Jul 1, 2024
Jeannae Dergance Individual Adp of the SNF Jul 1, 2024
Jay H Moskowitz Individual Corporate OfficerChief Executive Officer Jul 1, 2024 100%
Operational/Managerial Control Jul 1, 2024
Adp of the SNF Jul 1, 2024
Long Peak Opco LLC Organization, Sacramento, CA Created for acquisition, LLC, Holding company Direct Ownership Interest Jul 1, 2024 0.01%
Cynthia Haskell Individual Corporate OfficerChief Clinical Officer Jul 1, 2024 100%
Adp of the SNF Jul 1, 2024
Chaim M Raskin Individual Corporate OfficerPresident Jul 1, 2024 100%
Adp of the SNF Jul 1, 2024
Beecan Health Co LLC Organization, Glendale, CO LLC, Management services company, For-profit Adp of the SNF Jul 1, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1712620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1275386252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 ALLISON ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802146023",
            "telephone_number": "303-232-7177",
            "fax_number": "303-232-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 ALLISON ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802146023",
            "telephone_number": "303-232-7177",
            "fax_number": "303-232-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLISON CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR COST REPORTING",
        "authorized_official_telephone_number": "303-378-8320"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allison Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.