Pacifica Senior Living Re Fund LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PACIFICA SENIOR LIVING RE FUND LLC

Practice address

295 Rio Grande Ave
Carbondale, CO 81623-1704

Phone

(970) 340-4444

Fax

(970) 510-5140

NPI assigned

Jun 25, 2025

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 Cost Reporting

Phone

(720) 974-6278

Specialties & licenses 1

Addresses

Other names 1

• Sopris Lodge 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": "1750809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1457249757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 RIO GRANDE AVE",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816231704",
            "telephone_number": "970-340-4444",
            "fax_number": "970-510-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 RIO GRANDE AVE",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816231704",
            "telephone_number": "970-340-4444",
            "fax_number": "970-510-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFICA SENIOR LIVING RE FUND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR COST REPORTING",
        "authorized_official_telephone_number": "720-974-6278"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sopris Lodge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Carbondale, CO
• Providers in Carbondale, 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 Jun 25, 2025; 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.