Five Star Quality Care-Colorado LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1147 Issued in CO

Legal business name

FIVE STAR QUALITY CARE-COLORADO LLC

Doing business as

Willow Tree Care Center

Practice address

2050 S Main St
Delta, CO 81416-2407

Phone

(970) 874-9773

Fax

(970) 874-3611

NPI assigned

May 24, 2006

Organization subpart

Yes

Parent organization

FIVE STAR QUALITY CARE-COLORADO LLCAs reported in NPPES

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

Authorized official

Name

Katherine E Potter

Title

President & Chief Executive Officer

Phone

(617) 796-8387

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Willow Tree Care Center Doing business as

Part of

Five Star Quality Care-Colorado LLC

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1750336020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 S MAIN ST",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814162407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 S MAIN ST",
            "city": "DELTA",
            "state": "CO",
            "postal_code": "814162407",
            "telephone_number": "970-874-9773",
            "fax_number": "970-874-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR QUALITY CARE-COLORADO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR QUALITY CARE-COLORADO LLC",
        "enumeration_date": "2006-05-24",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "1147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64623041",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Tree Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mariah Emond, MS, LPC
• Amy D Engel, RD
• Alex Etzenhouser, PTA
• Exploration Kids Health
• Katie Fiske
• Five Star Quality Care-Colorado LLC
• Leslie T Flowers, LPC
• Josten Foley, CRNA
• Fortissimo Healthcare PLLC
• Karia Lyn Foster, LMT

• Skilled Nursing Facility in Delta, CO
• Providers in Delta, CO by specialty
• Skilled Nursing Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.