Hackberry Hill Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

020414 Issued in CO

Legal business name

HACKBERRY HILL OPCO LLC

Practice address

7991 W 71St Ave
Arvada, CO 80004-1828

Phone

(303) 403-3110

Fax

(303) 431-8903

NPI assigned

Jul 7, 2017

Organization subpart

No

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

Authorized official

Name

Mary Koretke

Title

Director of Reimbursement

Phone

(303) 238-3838

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Arbor View Doing business as

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513036800000",
    "number": "1306368717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12136 W BAYAUD AVE STE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282115",
            "telephone_number": "720-974-6278",
            "fax_number": "303-987-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7991 W 71ST AVE",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800041828",
            "telephone_number": "303-403-3110",
            "fax_number": "303-431-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKBERRY HILL OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-07",
        "last_updated": "2017-12-12",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "303-238-3838"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "020414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05650080",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "065330",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbor View",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• H2 Rehabilitation Extension Services LLC
• Kally Haag, PHARMD
• Mary Beth Haas, NURSE PRACTITIONER
• Mariam S Habashi
• Hackberry Hill Opco LLC
• Carol Ann Hackl, RPH
• John Hackney
• Joshua Matthew Hahn, LCSW, CAS
• Dana Marie Haines, NP
• John Peter Halfen IV, PA

• Skilled Nursing Facility in Arvada, CO
• Providers in Arvada, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.