Rock Canyon Healthcare LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ROCK CANYON HEALTHCARE LLC

Doing business as

The Villas at Rock Canyon

Practice address

1611 Alma Ave
Pueblo, CO 81004-2609

Phone

(719) 564-0550

Fax

(719) 404-1030

NPI assigned

Nov 6, 2014

Last updated

Aug 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Soon Burnam

Title

Treasurer

Phone

(949) 540-1249

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Villas at Rock Canyon Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Rock Canyon Healthcare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Rock Canyon Healthcare LLC

  dba Rock Canyon Respiratory and Rehabilitation Center

  • Skilled Nursing Facility
  • Pueblo, CO
  • NPI 1194121988
  NPD tax ID
• Rock Canyon Healthcare LLC

  • Skilled Nursing Facility
  • Pueblo, CO
  • NPI 1356912794
  NPD tax ID

Locations

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1285030072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 ALMA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042609",
            "telephone_number": "719-564-0550",
            "fax_number": "719-404-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 ALMA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042609",
            "telephone_number": "719-564-0550",
            "fax_number": "719-404-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK CANYON HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Villas at Rock Canyon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Villas at Rock Canyon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Waleed Robinson
• Camila Teresa Robles, DO
• Catherine Constance Robohn, RD/RDN
• Janessa Roche', MHPP
• Rock Canyon Healthcare LLC (Rock Canyon Respiratory and Rehabilitation Center)
• Rock Canyon Healthcare LLC
• Rock Canyon Healthcare LLC (Riverwalk Post Acute and Rehabilitation)
• Rocky Mountain Cancer Centers, LLP
• Rocky Mountain Cancer Centers, LLP (Rocky Mountain Cancer Centers-RMCC Pueblo)
• Rocky Mountain Clinics LLC

• Assisted Living Facility in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.