- Enrollment id
- O20250718002750
- Enrollment state
- CO
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1851136634
- Multiple npi flag
- N
- Ccn
- 065172
- Associate id
- 6507372398
- Organization name
- FOUNTAIN VIEW REHABILITATION AND NURSING LLC
- Doing business as name
- COTTONWOOD HEALTHCARE LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- FOUNTAIN VIEW REHABILITATION AND NURSING LLC
- Affiliation entity name
- THE CHARLY BELLO FAMILY, THE MAZE FAMILY, THE SWAIN FAMILY, & WALTER MYERS
- Affiliation entity id
- 803
- Address line 1
- 2438 E FOUNTAIN BLVD
- City
- COLORADO SPRINGS
- State
- CO
- Zip code
- 809103227