JACKSON CREEK ASSISTED LIVING, LLC (NPI# 1417421025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417421025 |
| Entity Type | Organization |
| Organization Name | JACKSON CREEK ASSISTED LIVING, LLC |
| Practice Address |
16601 Jackson Creek Parkway Monument CO 80132 |
| Mailing Address |
12136 W Bayaud Ave Ste 200 Lakewood CO 80228-2115 |
| Practice Telephone | 7197256060 |
| Practice Fax Number | 3039870434 |
| Mailing Telephone | 3032383838 |
| Mailing Fax Number | 3039870434 |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-01-16 |
| Authorized Official Name | MARY KORETKE (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 3032383838 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Jackson Creek Senior Living | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Jackson Creek Assisted Living, LLC | 16601 Jackson Creek Pkwy, Monument, CO 80132 |
| Street Address |
16601 JACKSON CREEK PARKWAY |
| City | MONUMENT |
| State | CO |
| Zip Code | 80132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407314131 | 100 Percent Chiropractic Rodgers LLC | Chiropractor | 1495 Cipriani Loop, Monument, CO 80132 | 2019-03-12 |
| 1609357144 | Baptist Road Dental | Dentist | 1036 Baptist Road, Monument, CO 80132 | 2018-08-23 |
| 1609352186 | Mountain Springs Recovery LLC | Substance Abuse Rehabilitation Facility | 1865 Woodmoor Dr, Monument, CO 80132 | 2018-07-17 |
| 1528553070 | Comfort Dental Oral Surgery Colorado Springs LLC | Dentist | 556 W. Hwy 105, Monument, CO 80132 | 2018-06-27 |
| 1265926844 | Lauren Elizabeth Nasuti | Massage Therapist | 17232 Jackson Creek Pkwy, #300, Monument, CO 80132 | 2018-06-18 |
| 1578079224 | Courtney Hopkins | Behavior Technician | 590 Hwy 105 Suite 105, Monument, CO 80132 | 2017-12-18 |
| 1033623475 | Deborah Tebault | Counselor | 220 N. Washington St., Suite F, Monument, CO 80132 | 2017-11-21 |
| 1902347578 | Monument Dentists and Orthodontics, LLP | Dentist | 950 W Baptist Road, Suite 100, Monument, CO 80132 | 2017-03-16 |
| 1972909463 | Timothy P O'connor | Counselor | 3065 Mt. Herman Rd., Monument, CO 80132 | 2014-11-10 |
| 1154759983 | 100 Percent Chiropractic Monument LLC | Chiropractor | 1793 Lake Woodmoor Drive, Monument, CO 80132 | 2013-10-14 |
| Find all providers in zip 80132 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285191023 | Bslc Monument, LLC | Assisted Living Facility | 55 Beacon Lite Rd, Monument, CO 80132-4400 | 2019-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881294825 | Tcal2 | Assisted Living Facility | 1069 S Teller St, Lakewood, CO 80226-4554 | 2020-10-29 |
| 1336749373 | Tcal2 | Assisted Living Facility | 6419 W Mexico Ave, Lakewood, CO 80232-7055 | 2020-10-29 |
| 1316553068 | Lower Valley Hospital Association | Assisted Living Facility | 243 N Cherry St, Fruita, CO 81521-2102 | 2020-09-18 |
| 1003427311 | Easley Senior Care LLC | Assisted Living Facility | 17351 W 64th Ave, Arvada, CO 80007-7796 | 2020-08-11 |
| 1528676111 | Pine Ridge Terrace Manor LLC | Assisted Living Facility | 378 S Pearl St, Elizabeth, CO 80107-7519 | 2020-07-20 |
| 1669090965 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 2240 Pratt St, Longmont, CO 80501-1497 | 2020-07-13 |
| 1699393728 | Planet View Inc. | Assisted Living Facility | 6994 County Road 39, Fort Lupton, CO 80621-8528 | 2020-07-06 |
| 1093339665 | Graceful Hearts Assisted Living | Assisted Living Facility | 6780 E Lake Cir, Centennial, CO 80111-4410 | 2020-05-30 |
| 1912520925 | Apex Assisted Living LLC | Assisted Living Facility | 3071 S Rosemary St, Denver, CO 80231-4186 | 2020-05-26 |
| 1477175172 | Eben Ezer Lutheran Care Center | Assisted Living Facility | 1910 Edison St, Brush, CO 80723-1743 | 2020-05-15 |
| Find all providers with the same taxonomy | ||||
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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.