Willow Crest, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL-0908 Issued in CO

Legal business name

WILLOW CREST, INC.

Practice address

1410 E. Buena Ventura St.
Colorado Springs, CO 80909-2825

Phone

(719) 473-6339

Fax

(719) 448-9301

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Karl D. Schmidt

Title

Pesident

Phone

(719) 473-6339

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crestview Manor, Inc. Doing business as

Tax ID family

Crestview Manor Inc2 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.

• Willow Crest, Inc.

  • Assisted Living Facility
  • Colorado Springs, CO
  • NPI 1124186093
  NPD tax ID

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316005234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 E. BUENA VENTURA ST.",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809092825",
            "telephone_number": "719-473-6339",
            "fax_number": "719-448-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E. BUENA VENTURA ST.",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809092825",
            "telephone_number": "719-473-6339",
            "fax_number": "719-448-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PESIDENT",
        "authorized_official_telephone_number": "719-473-6339",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "AL-0908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04141545",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crestview Manor, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Williston, DPT
• Bertram Willman, MD
• Willow and Courage Counseling, LLC
• Willow Creek Wellness LLC
• Willow Crest, Inc.
• Willows Counseling LLC
• Willows Counseling LLC
• Jenna Willsey
• Steven Willson
• Janet Rae Wilson-Armstrong, NNP

• Assisted Living Facility in Colorado Springs, CO
• Providers in Colorado Springs, 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 22, 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.