NPIMap

Organization Active NPI

Eben Ezer Lutheran Care Center

  • Assisted Living Facility
  • Brush, CO
National Provider Identifier
1477175172
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EBEN EZER LUTHERAN CARE CENTER
Practice address
1910 Edison St
Brush, CO 80723-1743
Phone
(970) 842-2861
NPI assigned
May 15, 2020
Last updated
May 15, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
EBEN EZER LUTHERAN CARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leslie Mason
Title
Cfo
Phone
(970) 842-2861

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1910 Edison St
Brush, CO 80723-1743

Mailing address

122 Hospital Rd
Brush, CO 80723-1702
Phone (970) 842-2861

Other identifiers 1

IdentifierTypeStateIssuer
04070330MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Eben Ezer in-Home Services9 organizations share this tax ID, including this one
Part of
Eben Ezer in-Home Services

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1477175172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 HOSPITAL RD",
            "city": "BRUSH",
            "state": "CO",
            "postal_code": "807231702",
            "telephone_number": "970-842-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 EDISON ST",
            "city": "BRUSH",
            "state": "CO",
            "postal_code": "807231743",
            "telephone_number": "970-842-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBEN EZER LUTHERAN CARE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EBEN EZER LUTHERAN CARE CENTER",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "970-842-2861"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04070330",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brush, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.