Loveland Elder Green House Homes for Life Enhancement

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

02F496 Issued in CO

Legal business name

LOVELAND ELDER GREEN HOUSE HOMES FOR LIFE ENHANCEMENT

Doing business as

The Green House Homes at Mirasol

Practice address

490 Mirasol Dr
Loveland, CO 80537-2339

Phone

(970) 342-2400

Fax

(970) 342-2267

NPI assigned

Dec 17, 2015

Organization subpart

No

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

Authorized official

Name

Mary Koretke

Title

Director of Reimbursement

Phone

(720) 974-6278

Specialties & licenses 1

Addresses

Other names 1

• The Green House Homes at Mirasol Doing business as

Tax ID family

Loveland Elder Green House Homes for Life Enrichment a Colorado Non2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Loveland Elder Green House Homes for Life Enrichment a Colorado Non

  • Skilled Nursing Facility
  • Loveland, CO
  • NPI 1598176828
  NPD tax ID

Locations

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1932564994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 MIRASOL DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805372339",
            "telephone_number": "970-342-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 MIRASOL DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805372339",
            "telephone_number": "970-342-2400",
            "fax_number": "970-342-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVELAND ELDER GREEN HOUSE HOMES FOR LIFE ENHANCEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "720-974-6278"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "02F496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Green House Homes at Mirasol",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Green House Homes at Mirasol",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Loveland, CO
• Providers in Loveland, 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 Dec 23, 2021; 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.