NPIMap

Organization Active NPI

Lafayette Community Healthcare, LLC

  • Skilled Nursing Facility
  • Lafayette, CO
National Provider Identifier
1629762000
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LAFAYETTE COMMUNITY HEALTHCARE, LLC
Practice address
329 Exempla Cir
Lafayette, CO 80026-3482
Phone
(720) 639-2200
NPI assigned
Jun 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Authorized official

Name
Alicia Cepeda
Title
Senior Legal/Risk Manager
Phone
(385) 342-5175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

329 Exempla Cir
Lafayette, CO 80026-3482

Mailing address

90 S 400 W Ste 700
Salt Lake City, UT 84101-1431

Other names 1

  • Coal Creek Post Acute & Assisted Living Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231031001741 CO Part A Provider - Skilled Nursing Facility 7618323403 Practice locations: Lafayette, CO

Skilled nursing facility certification: CCN 065414

Legal name
LAFAYETTE COMMUNITY HEALTHCARE LLC
Doing business as
COAL CREEK POST ACUTE & ASSISTED LIVING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 24, 2015
Last certification
Feb 29, 2024
Beds
70
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Jun 5, 2023 in CO
Enrollment address
329 Exempla Cir
Lafayette, CO 80026-3482
Nursing home name
COAL CREEK POST ACUTE & ASSISTED LIVING
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Coal Creek Post Acute & Assisted LivingCCN 065414
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 24, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7058.7 residents per day on average
Chain
Pacs Group274 facilities in the chain
Penalties (3 years)
1Fines totaling $0

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2091465Coal Creek Post Acute and Assisted Living329 Exempla Cir, Lafayette, CO 80026Certificate of waiverFeb 12, 2027

National Provider Directory

National Provider Directory

Locations

90 S 400 W
Ste 700
Salt Lake City, UT 84101

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
Panther Master Tenant, LLC Organization, Farmington, UT LLC, For-profit 5% Or Greater Direct Ownership Interest Sep 1, 2023 100%
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Reza S Esfahani Individual Contracted Managing EmployeeMD; Mar 1, 2015
Providence Group NH, LLC Organization, Lafayette, CO LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2023 100%
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Carly Bader Individual W-2 Managing EmployeeAdministrator Sep 1, 2023
Pacs Group, Inc. Organization, Farmington, UT Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
Corporate OfficerCeo Jan 1, 2024

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 186

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

View all 186

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1629762000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S 400 W STE 700",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 EXEMPLA CIR",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263482",
            "telephone_number": "720-639-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE COMMUNITY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-07",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "CEPEDA",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "SENIOR LEGAL/RISK MANAGER",
        "authorized_official_telephone_number": "385-342-5175"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coal Creek Post Acute & Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.