QL-Cambridge Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

020441 Issued in CO

Legal business name

QL-CAMBRIDGE CARE CENTER, LLC

Doing business as

Cambridge Care Center

Practice address

1685 Eaton St
Lakewood, CO 80214-1628

Phone

(303) 232-4405

Fax

(303) 232-0805

NPI assigned

Feb 11, 2016

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

(720) 974-6278

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cambridge Care Center Doing business as

Tax ID family

Cambridge Care Center2 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.

• QL-Cambridge Care Center, LLC

  • Skilled Nursing Facility
  • Lakewood, CO
  • NPI 1043203631
  NPD tax ID

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461974400000",
    "number": "1447619960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 EATON ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802141628",
            "telephone_number": "303-232-4405",
            "fax_number": "303-232-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 EATON ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802141628",
            "telephone_number": "303-232-4405",
            "fax_number": "303-232-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QL-CAMBRIDGE CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-04-30",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "720-974-6278"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "020441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26629330",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cambridge Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasmine Pyne, RBT
• Magdalena Pyrtek Smith, BCBA
• QL-Allison Care Center
• QL-Allison Care Center, LLC
• QL-Cambridge Care Center, LLC
• QL-Harmony Pointe Nursing Center, LLC
• QL-Harmony Pointe Nursing Center, LLC
• Stacy Alice Quackenbush
• Alexandra Brooks Quade, MA LPC
• Jeffrey P Quam, M.D.

• Skilled Nursing Facility in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2016; 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.