Bethesda Gardens Broadmoor Court LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BETHESDA GARDENS BROADMOOR COURT LLC

Doing business as

Broadmoor Court

Practice address

2045 Roanoke St
Colorado Springs, CO 80906-3451

Phone

(719) 471-2286

Fax

(719) 634-0491

NPI assigned

May 4, 2021

Organization subpart

No

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

Authorized official

Name

Diane Wilson

Title

Accounting Manager

Phone

(719) 481-0100

Specialties & licenses 1

Addresses

Other names 1

• Broadmoor Court Doing business as

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1669055935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15475 GLENEAGLE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809212596",
            "telephone_number": "719-481-0100",
            "fax_number": "719-488-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 ROANOKE ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063451",
            "telephone_number": "719-471-2286",
            "fax_number": "719-634-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA GARDENS BROADMOOR COURT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "719-481-0100"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadmoor Court",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Colorado Springs, CO
• Providers in Colorado Springs, 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 May 4, 2021; 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.