Gengreenmountain LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GENGREENMOUNTAIN LLC

Doing business as

Montage Ridge

Practice address

12791 W Alameda Pkwy
Lakewood, CO 80228-2838

Phone

(503) 652-0750

NPI assigned

Oct 11, 2019

Last updated

Nov 15, 2023By 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

Rebecca Stayner

Title

Director of Compliance

Phone

(503) 594-2263

Specialties & licenses 2

Addresses

Other names 1

• Montage Ridge 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

Locations

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1366084212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8440 SE SUNNYBROOK BLVD STE 100",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155781",
            "telephone_number": "503-652-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 W ALAMEDA PKWY",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282838",
            "telephone_number": "503-652-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENGREENMOUNTAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-11",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "STAYNER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "503-594-2263"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montage Ridge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Montage Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey Geiselman
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• Elizabeth Katherine Gerber, BCBA
• Geri-Care Inc (Grand Oaks Care Center)

• Assisted Living Facility in Lakewood, CO
• Providers in Lakewood, 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 Nov 15, 2023; 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.