NPI: 1609634260 · LAFAYETTE, CO 80026 · Assisted Living Facility · NPI assigned 03/08/2024
| Authorized Official | KIKLIS, DEAN (CFO) |
| NPI Enumeration Date | 03/08/2024 |
Other providers sharing the same authorized official: KIKLIS, DEAN
| Provider | City | State | Total Paid |
|---|---|---|---|
| 1111 BONFORTE OPCO, LLC | PUEBLO | CO | $60K |
| GARDEN VALLEY RETIREMENT VILLAGE, LLC | GARDEN CITY | KS | $0.00 |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 135 | $375K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2031 | Assisted living; waiver, per diem | 135 | 132 | $375K |