Residence at Skyway Park

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

23S681 Issued in CO

Legal business name

RESIDENCE AT SKYWAY PARK

Practice address

886 Arcturus Dr
Colorado Springs, CO 80905-7832

Phone

(719) 227-7340

Fax

(719) 227-7344

NPI assigned

Sep 9, 2009

Organization subpart

No

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

Authorized official

Name

Robert Matrazzo

Title

Coo

Phone

(305) 444-5007

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252454400000",
    "number": "1689907792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "886 ARCTURUS DRIVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809057832",
            "telephone_number": "719-227-7340",
            "fax_number": "719-227-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 ARCTURUS DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809057832",
            "telephone_number": "719-227-7340",
            "fax_number": "719-227-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENCE AT SKYWAY PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-09-09",
        "status": "A",
        "authorized_official_last_name": "MATRAZZO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "305-444-5007"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23S681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.