Healthcare Provider Details
I. General information
NPI: 1417813015
Provider Name (Legal Business Name): GM 465 BURLINGTON OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
465 5TH ST
BURLINGTON CO
80807-1932
US
IV. Provider business mailing address
2668 NORTHPARK DR
LAFAYETTE CO
80026-3199
US
V. Phone/Fax
- Phone: 719-346-7512
- Fax:
- Phone: 303-952-9216
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
VELUSCEK
Title or Position: PRESIDENT OF MEMBER
Credential:
Phone: 303-952-9216