1518507680 NPI number — ROCK CREEK INVESTMENTS LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518507680 NPI number — ROCK CREEK INVESTMENTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCK CREEK INVESTMENTS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ROCK CREEK ASSISTED LIVING AT SOMERSET
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518507680
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
930 W GOLF VIEW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORO VALLEY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85737-9131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-399-2146
Provider Business Mailing Address Fax Number:
888-371-2955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1109 S RIFLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80017-4526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-535-1401
Provider Business Practice Location Address Fax Number:
37-457-9973
Provider Enumeration Date:
01/07/2020

Additional Information

Authorized Official

Authorized Official Last Name:
PRICE
Authorized Official First Name:
NEAL
Authorized Official Middle Name:
M
Authorized Official Title or Position:
MANGING PARTNER
Authorized Official Telephone Number:
541-399-2146

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 60589787 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 56121784 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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