NPI 1528676111

Pine Ridge Terrace Manor LLC

Organisation Assisted Living Facility Elizabeth, CO

Practice location

Address: 378 S Pearl St, Elizabeth, CO 80107-7519
Phone: (720) 398-9787
Fax: (720) 696-7932

Authorised official

Name: Alexander M Lagasca
Title: Administrator
Phone: (720) 398-9787

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1528676111
Entity type: Organization
NPI issued: 20 Jul 2020
Record last updated: 15 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.