MONTAGE RIDGE
NPI 1366084212
Assisted Living Facility in Lakewood, CO

Q: What is Gengreenmountain LLC's NPI number?

The NPI number for Gengreenmountain LLC is 1366084212. It was assigned to this organization in the NPPES registry on October 11, 2019. The provider is doing business as Montage Ridge.

Q: What is Gengreenmountain LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since October 11, 2019CLIA 06D2203132 · Waiver

12791 W ALAMEDA PKWY, LAKEWOOD, CO 80228(503) 652-0750 Get Directions Write a Review

NPPES record last updated: November 15, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 15, 2023, Oct 11, 2019 (2 updates tracked since 2019).

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About Montage Ridge NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MONTAGE RIDGE (NPI 1366084212) is a healthcare organization registered as an assisted living facility in Lakewood, Colorado and active in the NPI registry since October 2019. The organization holds a CLIA Waiver certificate valid through December 1, 2026 and lists Rebecca Stayner, Director Of Compliance, as its authorized official.

NPPES Registry Identity

NPI1366084212

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameGENGREENMOUNTAIN LLC

Location Address12791 W ALAMEDA PKWYLakewood, CO 80228-2838

Mailing Address8440 Se Sunnybrook Blvd Ste 100Clackamas, OR 97015-5781 · (503) 652-0750

Phone(503) 652-0750

Organization SubpartNo

Authorized OfficialRebecca StaynerDirector Of Compliance · (503) 594-2263

Enumeration DateOctober 11, 2019

Last NPPES UpdateNovember 15, 20232 updates tracked since enumeration

NPPES CertifiedNovember 15, 2023

✔ NPI 1366084212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

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.

Also ListedSkilled Nursing FacilityTaxonomy 314000000X

12791 W ALAMEDA PKWY, Lakewood, CO 80228

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Other Names 1

Doing Business AsMontage Ridge

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 06D2203132

Montage Ridge Assisted Living · Lakewood, CO

Active · expires Dec 1, 2026

CLIA Number06D2203132

Laboratory TypeAssisted Living Facility

Certificate Effective DateDecember 2, 2024

Certificate Expiration DateDecember 1, 2026

Laboratory DirectorDr. Reza Esfahani

Laboratory Phone(303) 237-5700

Laboratory LocationMontage Ridge Assisted Living12791 W Alameda Parkway, Lakewood, CO 80228

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATELYN BURNS D.P.T.

Physical Therapist