Organization Active NPI

Canyon View Care Center LLC

Doing business as Canyon View Care Center

  • Skilled Nursing Facility
  • Palisade, CO
National Provider Identifier
1528890852
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CANYON VIEW CARE CENTER LLC
Doing business as
Canyon View Care Center
Practice address
151 E 3Rd St
Palisade, CO 81526-5006
Phone
(970) 464-7500
Fax
(970) 464-0815
NPI assigned
Aug 15, 2024
Last updated
Aug 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

151 E 3Rd St
Palisade, CO 81526-5006

Mailing address

151 E 3Rd St
Palisade, CO 81526-5006
Phone (970) 464-7500

Other names 1

  • Canyon View Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250506002852 CO Part A Provider - Skilled Nursing Facility 5698292381 Practice locations: Palisade, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528890852. Details of each certification follow.

Skilled nursing facility certification: CCN 065228

Legal name
CANYON VIEW CARE CENTER LLC
Doing business as
CANYON VIEW CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1986
Last certification
Jul 23, 2024
Beds
88
Ownership / control type
Corporation
Multi-facility organization
Beecan Vivage
Most recent change of ownership
Sep 1, 2024
Organization structure
LLCProprietary
Enrollment address
151 E 3Rd St
Palisade, CO 81526-5006
Nursing home name
CANYON VIEW CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Canyon View Care CenterCCN 065228 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 1, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8874.4 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
2Fines totaling $28,322

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Canyon View 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.

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Karla Valle Individual Corporate OfficerChief Operating Officer Sep 1, 2024 100%
Adp of the SNF Sep 1, 2024
Mary E Koretke Individual Adp of the SNF Sep 1, 2024
Jeannae Dergance Individual Adp of the SNF Sep 1, 2024
Jamie Lee Noble Individual Operational/Managerial Control Mar 10, 2016
Adp of the SNF Mar 10, 2016
Jay H Moskowitz Individual Corporate OfficerChief Executive Officer Sep 1, 2024 100%
Adp of the SNF Sep 1, 2024
Cynthia Haskell Individual Adp of the SNF Sep 1, 2024
Canyon View SNF Holdings LLC Organization, Sacramento, CA Created for acquisition, LLC, Holding company 5% Or Greater Direct Ownership Interest Sep 1, 2024 99.99%
Chaim M Raskin Individual Corporate DirectorPresident Mar 1, 2023 100%
Adp of the SNF Sep 1, 2024
Organization, Sacramento, CA Created for acquisition, LLC, Holding company Direct Ownership Interest Sep 1, 2024 0.01%
Beecan Health Co LLC Organization, Denver, CO LLC, Management services company Operational/Managerial Control Sep 1, 2024
Adp of the SNF Mar 13, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1528890852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E 3RD ST",
            "city": "PALISADE",
            "state": "CO",
            "postal_code": "815265006",
            "telephone_number": "970-464-7500",
            "fax_number": "970-464-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E 3RD ST",
            "city": "PALISADE",
            "state": "CO",
            "postal_code": "815265006",
            "telephone_number": "970-464-7500",
            "fax_number": "970-464-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON VIEW CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canyon View Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palisade, CO

Sources for this page

Verify at the official NPI Registry.