GENGREENMOUNTAIN LLC (NPI# 1366084212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366084212 |
| Entity Type | Organization |
| Organization Name | GENGREENMOUNTAIN LLC |
| Practice Address |
12791 W Alameda Pkwy Lakewood CO 80228-2838 |
| Mailing Address |
8440 Se Sunnybrook Blvd Ste 100 Clackamas OR 97015-5781 |
| Practice Telephone | 5036520750 |
| Mailing Telephone | 5036520750 |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2019-10-11 |
| Authorized Official Name | REBECCA STAYNER (DIRECTOR OF COMPLIANCE) |
| Authorized Official Telephone | 5035942263 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Montage Ridge | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | GenGreenMountain LLC | 8440 Se Sunnybrook Blvd, Ste 100, Clackamas, OR 97015 |
| Street Address |
12791 W ALAMEDA PKWY |
| City | LAKEWOOD |
| State | CO |
| Zip Code | 80228-2838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881659332 | Senior Living of Lakewood, LLC | Skilled Nursing Facility | 12791 W Alameda Pkwy, Lakewood, CO 80228-2857 | 2006-04-19 |
| 1124456280 | Katelyn Burns | Physical Therapist | 12791 W Alameda Pkwy, Lakewood, CO 80228-2838 | 2013-10-28 |
| 1831433424 | Merrie Beth Golembiewski | Occupational Therapy Assistant | 12791 W Alameda Pkwy, Lakewood, CO 80228-2838 | 2012-11-20 |
| 1417206707 | Sheena Danielle Boyce | Speech-Language Pathologist | 12791 W Alameda Pkwy, Lakewood, CO 80228-2838 | 2012-09-03 |
| 1154693406 | Sarah Loveland | Occupational Therapist | 12791 W Alameda Pkwy, Lakewood, CO 80228-2838 | 2012-02-02 |
| 1720361793 | Christina Thomas | Speech-Language Pathologist | 12791 W Alameda Pkwy, Lakewood, CO 80228-2838 | 2011-09-26 |
| 1528341591 | Beverly A Fischer | Occupational Therapy Assistant | 12791 W Alameda Pkwy, Lakewood, CO 80228-2838 | 2011-09-26 |
| 1801104195 | Emericare Inc | Skilled Nursing Facility | 12791 W Alameda Pkwy, Lakewood, CO 80228-2838 | 2010-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174083570 | Lindsey Mae Beverly | Physician Assistant | Medical Plaza 2, 11700 W 2nd Pl, #350, Lakewood, CO 80228 | 2019-03-21 |
| 1881119931 | Cory J Frazier | Nurse Practitioner | 11600 W. 2nd Pl, Lakewood, CO 80228 | 2017-08-10 |
| 1508213885 | Chelsea Tucker | Counselor | 12157 W Cedar Dr Ste 207, Lakewood, CO 80228 | 2016-05-17 |
| 1972963841 | Shastin Gerbracht | Counselor | 12055 W 2nd Pl, Ste 200, Lakewood, CO 80228 | 2016-03-04 |
| 1073983375 | Suzanne Phillips | Behavioral Analyst | 200 Union Blvd. Ste. 200, Lakewood, Co. 80228, Denver, CO 80228 | 2015-09-29 |
| 1700265667 | April Mearsha | Doula | 12977 W Cedar Dr, 2-305, Lakewood, CO 80228 | 2015-05-26 |
| 1306233713 | Caleb Hedberg | Internal Medicine | 165 S Union Blvd Ste 800, Lakewood, CO 80228 | 2015-04-23 |
| 1972996288 | David Lindsey Currie | Counselor | 12055 W 2nd Place, Jefferson Ctr for Mental Health, Lakewood, CO 80228 | 2015-03-11 |
| 1619365533 | Michelle Broberg II | Technician | 12055 West 2nd Plaza, Lakewood, CO 80228 | 2014-12-30 |
| 1750789012 | Kayla Morrison | Social Worker | 12005 W 2nd Place, Lakewood, CO 80228 | 2014-12-18 |
| Find all providers in zip 80228 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124656202 | Bedrock Hcs At Daytona Fl LLC | Skilled Nursing Facility | 1776 Avenue of The States Ste 301, Lakewood, NJ 08701-4592 | 2020-04-01 |
| 1871154419 | Ahc of Lakewood, LLC | Skilled Nursing Facility | 1565 Pierson Street, Lakewood, CO 80215 | 2019-06-25 |
| 1639631104 | West Salem Operations LLC | Skilled Nursing Facility | 23 Shenandoah Dr, Lakewood, NJ 08701-4979 | 2019-04-03 |
| 1720520729 | Meghan Ricketson | Skilled Nursing Facility | 5962 W Pacific Cir, Lakewood, CO 80227-2583 | 2016-11-08 |
| 1932564994 | Loveland Elder Green House Homes for Life Enhancement | Skilled Nursing Facility | 12136 W Bayaud Ave Ste 200, Lakewood, CO 80228-2115 | 2015-12-17 |
| 1598176828 | Loveland Elder Green House Homes for Life Enrichment A Colorado Non | Skilled Nursing Facility | 12136 W Bayaud Ave, Suite 200, Lakewood, CO 80228-2115 | 2014-05-08 |
| 1588089676 | 7395 W Eastman Place Operations LLC | Skilled Nursing Facility | 7395 W. Eastman Place, Lakewood, CO 80227-1234 | 2014-02-26 |
| 1275855058 | Azura of Lakewood, LLC | Skilled Nursing Facility | 7395 West Eastman Place, Lakewood, CO 80227-5039 | 2010-02-22 |
| 1922147784 | W IIi, Inc. | Skilled Nursing Facility | 1655 Eaton St, Lakewood, CO 80214-1628 | 2007-02-06 |
| 1750431912 | Mile High Care Services LLC | Skilled Nursing Facility | 115 Ingalls St, Lakewood, CO 80226-1815 | 2007-01-11 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.