NPIMap

Organization Active NPI

SNH Co Tenant LLC

Doing business as Skyline Ridge Nursing and Rehabilitation Center

  • Respite Care
  • Canon City, CO
National Provider Identifier
1770120065
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
Legal business name
SNH CO TENANT LLC
Doing business as
Skyline Ridge Nursing and Rehabilitation Center
Practice address
515 Fairview Ave
Canon City, CO 81212-2863
Phone
(719) 275-0665
Fax
(719) 275-6225
NPI assigned
Dec 5, 2019
Last updated
May 1, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SNH CO TENANT LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Authorized official

Name
Jennifer F. Mintzer
Title
President & Chief Operating Officer
Phone
(617) 796-8350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X NU Primary

Addresses

Primary practice location

515 Fairview Ave
Canon City, CO 81212-2863

Mailing address

255 Washington St Ste 300
Newton, MA 02458-1634
Phone (617) 796-8350

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidCO

Other names 1

  • Skyline Ridge Nursing and Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
SNH Co Tenant LLC13 organizations share this tax ID, including this one
Part of
SNH Co Tenant LLC

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588291200000",
    "number": "1770120065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 300",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581634",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FAIRVIEW AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122863",
            "telephone_number": "719-275-0665",
            "fax_number": "719-275-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH CO TENANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SNH CO TENANT LLC",
        "enumeration_date": "2019-12-05",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A",
        "authorized_official_last_name": "MINTZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "617-796-8350"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skyline Ridge Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; 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.