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PINE RIDGE EXTENDED CARE CENTER
NPI 1922005644
Assisted Living Facility in Pagosa Springs, CO

Active since July 07, 2005
119 BASTILLE DR, PAGOSA SPRINGS, CO 81147(970) 731-4330(970) 731-4046 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pine Ridge Extended Care Center NPPES

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

PINE RIDGE EXTENDED CARE CENTER (NPI 1922005644) is a healthcare organization registered as an assisted living facility in Pagosa Springs, Colorado and active in the NPI registry since July 2005. The organization lists Mary J Brooks, Nusing Home Administrator, as its authorized official.

NPPES Registry Identity

NPI1922005644
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePINE RIDGE EXTENDED CARE CENTER
Location Address119 BASTILLE DRPagosa Springs, CO 81147-9388
Mailing Address119 Bastille DrPagosa Springs, CO 81147-9388 · (970) 731-4330 · Fax (970) 731-4046
Phone(970) 731-4330
Fax(970) 731-4046
Organization SubpartNo
Authorized OfficialMary J BrooksNusing Home Administrator · (970) 731-4330
Enumeration DateJuly 7, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1922005644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in CO · AL0228
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.
119 BASTILLE DR, Pagosa Springs, CO 81147
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Other Identifiers 1

Medicaid04143434CO

Other Providers at the Same Location NPPES 15

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

PINE RIDGE REHABILITATION AND HEALTHCARE CENTER LLC
Respite Care
119 BASTILLE DR
PAGOSA SPRINGS, CO 81147
Archuleta County (970) 731-4330
ALLISON QUALLS COTA
Occupational Therapy Assistant
119 BASTILLE DR
PAGOSA SPRINGS, CO 81147
Archuleta County (970) 731-4330
PINE RIDGE EXTEND CARE CENTER, LLC
Skilled Nursing Facility
119 BASTILLE DR
PAGOSA SPRINGS, CO 81147
Archuleta County (970) 731-4330
MRS. KRISTIN RENEE OVENSHIRE MOREHOUSE MSOT. MED
Occupational Therapist
119 BASTILLE DR
PAGOSA SPRINGS, CO 81147
Archuleta County (970) 731-4041
PINE RIDGE EXTENDED CARE CENTER, LLC
Respite Care
119 BASTILLE DR
PAGOSA SPRINGS, CO 81147
Archuleta County (970) 731-4330
KIMBERLY DENNIS
Physical Therapy Assistant
119 BASTILLE DR
PAGOSA SPRINGS, CO 81147
Archuleta County (970) 731-4330
TANJA MOREHOUSE
Physical Therapy Assistant
119 BASTILLE DR
PAGOSA SPRINGS, CO 81147
Archuleta County (970) 731-4330
ERICA J ROBINSON
Physical Therapy Assistant
119 BASTILLE DR
PAGOSA SPRINGS, CO 81147
Archuleta County (970) 731-4330

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pine Ridge Extended Care Center's NPI number?

The NPI number for Pine Ridge Extended Care Center is 1922005644. It was assigned to this organization in the NPPES registry on July 7, 2005.

Where is Pine Ridge Extended Care Center located?

Pine Ridge Extended Care Center is located at 119 Bastille Dr, Pagosa Springs, CO 81147. The listed phone number is (970) 731-4330.

What is Pine Ridge Extended Care Center's specialty?

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

When was this NPI record last updated?

The NPPES record for Pine Ridge Extended Care Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.