Healthcare Provider Details

I. General information

NPI: 1457066409
Provider Name (Legal Business Name): 850 ORCHARD MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 E ORCHARD RD
CENTENNIAL CO
80121-2479
US

IV. Provider business mailing address

4950 S YOSEMITE ST
GREENWOOD VILLAGE CO
80111-1349
US

V. Phone/Fax

Practice location:
  • Phone: 650-847-7287
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: LORETTA CHANG
Title or Position: CEO
Credential:
Phone: 650-847-7287