Re II Senior III Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

RE II SENIOR III OPCO LLC

Practice address

4255 Spencer St
Las Vegas, NV 89119-5545

Phone

(702) 732-0652

Fax

(702) 732-9520

NPI assigned

Mar 19, 2021

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) 378-8320

Specialties & licenses 1

Addresses

Other names 1

• Sterling Ridge Senior Center 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

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1417533548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 SPENCER ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195545",
            "telephone_number": "702-732-0652",
            "fax_number": "702-732-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 SPENCER ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195545",
            "telephone_number": "702-732-0652",
            "fax_number": "702-732-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RE II SENIOR III OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "303-378-8320"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sterling Ridge Senior Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Assisted Living Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.