Healthcare Provider Details
I. General information
NPI: 1275445330
Provider Name (Legal Business Name): MADISON ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 S MADISON ST
CORTEZ CO
81321-3734
US
IV. Provider business mailing address
9440 GOLDEN OAK PL
PARKER CO
80134-4544
US
V. Phone/Fax
- Phone: 720-382-9288
- Fax:
- Phone: 720-382-9288
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PARULO
DARJI
Title or Position: OWNER
Credential: RN
Phone: 720-382-9288