Crest Ridge Memory Care

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

2311EW Issued in CO

Legal business name

CREST RIDGE MEMORY CARE

Practice address

972 Walnut Ave
Grand Junction, CO 81501-2952

Phone

(970) 985-4122

Fax

(970) 985-4123

NPI assigned

Dec 18, 2015

Organization subpart

No

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

Authorized official

Name

Chelsea S Hoffman

Title

Owner

Phone

(970) 712-3001

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1922463843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 WALNUT AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012952",
            "telephone_number": "970-985-4122",
            "fax_number": "970-985-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 WALNUT AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012952",
            "telephone_number": "970-985-4122",
            "fax_number": "970-985-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREST RIDGE MEMORY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-712-3001"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "CO",
            "license": "2311EW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Assisted Living Facility (Mental Illness) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.