Provider Demographics
NPI:1316285729
Name:WIND CREST, INC.
Entity type:Organization
Organization Name:WIND CREST, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-402-2315
Mailing Address - Street 1:3235 MILL VISTA RD
Mailing Address - Street 2:ATTN: EXECUTIVE DIRECTOR
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2440
Mailing Address - Country:US
Mailing Address - Phone:303-798-3100
Mailing Address - Fax:410-204-7237
Practice Address - Street 1:3235 MILL VISTA RD
Practice Address - Street 2:ATTN: EXECUTIVE DIRECTOR
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2440
Practice Address - Country:US
Practice Address - Phone:303-798-3100
Practice Address - Fax:410-204-7237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23A843314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO065409Medicare Oscar/Certification