Greenwood Manor Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

23062L Issued in CO

Legal business name

GREENWOOD MANOR INC

Practice address

421 W 11TH St
Pueblo, CO 81003-2806

Phone

(719) 778-2934

Fax

(719) 542-6098

NPI assigned

May 29, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Carter Wells

Title

Administrator

Phone

(719) 778-2934

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527552000000",
    "number": "1871084574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W 11TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032806",
            "telephone_number": "719-778-2934",
            "fax_number": "719-542-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W 11TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032806",
            "telephone_number": "719-778-2934",
            "fax_number": "719-542-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "CARTER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "719-778-2934",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23062L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarnell Joseph Green
• Kayleigh R Greenfield, COTA/L
• Greenhorn Family Dentistry LLC
• Nancy Lea Greenstreet, LCSW
• Greenwood Ear Nose & Throat Specialists PC
• Andrew Jerry Greenwood, DO
• Laura L. Greenwood
• Michael Greenwood, OTR
• Greg Philson DDS PC
• Gregory Homes

• Assisted Living Facility in Pueblo, CO
• Providers in Pueblo, 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 29, 2018; 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.