Diversicare of Delta, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DIVERSICARE OF DELTA, LLC

Doing business as

Diversicare of Delta

Practice address

2050 S Main St
Delta, CO 81416-2407

Phone

(970) 874-9773

Fax

(615) 620-7875

NPI assigned

May 23, 2015

Organization subpart

Yes

Parent organization

DIVERSICARE LEASING COMPANY II, LLCAs reported in NPPES

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

Authorized official

Name

Kelly J Gill

Title

President & Ceo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other names 1

• Diversicare of Delta Doing business as

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

{
    "created_epoch": "1432339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432339200000",
    "number": "1851770812",
    "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",
            "telephone_number": "970-874-9773",
            "fax_number": "615-620-7875"
        },
        {
            "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": "615-620-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE OF DELTA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSICARE LEASING COMPANY II, LLC",
        "enumeration_date": "2015-05-23",
        "last_updated": "2015-05-23",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diversicare of Delta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 May 23, 2015; 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.