NPIMap

Organization Active NPI

State of Colorado

  • Skilled Nursing Facility
  • Monte Vista, CO
National Provider Identifier
1326620261
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
STATE OF COLORADO
Doing business as
Colorado Veterans Community Living Center Homelake
Practice address
3749 Sherman Ave
Monte Vista, CO 81144-9403
Phone
(719) 852-8211
Fax
(719) 852-3881
NPI assigned
Apr 21, 2021
Organization subpart
Yes
Parent organization
STATE OF COLORADOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Ginger Butero
Title
Accountant
Phone
(719) 852-5118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3749 Sherman Ave
Monte Vista, CO 81144-9403

Mailing address

PO Box 97
Homelake, CO 81135-0097
Phone (719) 852-8211

Other identifiers 1

IdentifierTypeStateIssuer
9000179367MedicaidCO

Other names 1

  • Colorado Veterans Community Living Center Homelake Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Colorado State Veterans Nursing Home102 organizations share this tax ID, including this one
Part of
Colorado State Veterans Nursing Home

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1326620261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "HOMELAKE",
            "state": "CO",
            "postal_code": "811350097",
            "telephone_number": "719-852-8211",
            "fax_number": "719-852-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3749 SHERMAN AVE",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811449403",
            "telephone_number": "719-852-8211",
            "fax_number": "719-852-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF COLORADO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF COLORADO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "BUTERO",
        "authorized_official_first_name": "GINGER",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "719-852-5118"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000179367",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado Veterans Community Living Center Homelake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monte Vista, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.