Community Assisted Living, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL-0001 Issued in CO

Legal business name

COMMUNITY ASSISTED LIVING, INC

Doing business as

Cottonwood Ridge

Practice address

1122 S 12TH St
Rocky Ford, CO 81067-2400

Phone

(719) 854-3667

Fax

(719) 254-3823

NPI assigned

Mar 29, 2006

Last updated

Aug 22, 2020By 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

Donald Kanen

Title

Cfo

Phone

(719) 589-2063

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cottonwood 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

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437110509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 MULLINS AVE",
            "address_2": "SUITE 4",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811014274",
            "telephone_number": "719-589-2063",
            "fax_number": "719-589-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 S 12TH ST",
            "city": "ROCKY FORD",
            "state": "CO",
            "postal_code": "810672400",
            "telephone_number": "719-854-3667",
            "fax_number": "719-254-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ASSISTED LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KANEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "719-589-2063"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "AL-0001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7173825",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cottonwood Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sariah Anne Berg, FNP-C
• Aleala Bickel, PTA
• Heather Danelle Blair
• Britany D Chamberlain
• City of Rocky Ford (Rocky Ford Emergency Service)
• Council of Preventive & Supportive Services for the Aging (SAGE Services, Inc)
• Miciah William Davis, PHARM D.
• Heather A Elliott, MSN, NP-C
• Melissa M Foley, PH.D.
• Bethany Mae Grap, COTA/L

• Assisted Living Facility in Rocky Ford, CO
• Providers in Rocky Ford, 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.
• 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.