Basic Information
| Provider Information | |||||||||
| NPI: | 1578832226 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ERB OPCO SAV, LLC | ||||||||
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| OtherOrganizationName: | ST. ANDREW'S VILLAGE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 WESTWOOD PL | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370275021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152212262 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2670 S. ABILENE ST. W | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800142336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036959300 | ||||||||
| FaxNumber: | 3036958101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2011 | ||||||||
| LastUpdateDate: | 03/19/2014 | ||||||||
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| AuthorizedOfficialLastName: | COATES | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 6152212262 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3140N1450X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility | Nursing Care, Pediatric |
No ID Information.