Healthcare Provider Details

I. General information

NPI: 1528673217
Provider Name (Legal Business Name): GATEWAY HOSPICE DENVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2696 S COLORADO BLVD STE 570
DENVER CO
80222-5954
US

IV. Provider business mailing address

3636 NOBEL DR STE 450
SAN DIEGO CA
92122-1062
US

V. Phone/Fax

Practice location:
  • Phone: 303-747-6377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SUOR
Title or Position: CEO
Credential:
Phone: 858-251-4242