Healthcare Provider Details

I. General information

NPI: 1356324578
Provider Name (Legal Business Name): LITTLE SISTERS OF THE POOR MULLEN HOME FOR THE AGED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 04/22/2022
Certification Date: 04/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3629 W 29TH AVE
DENVER CO
80211-3601
US

IV. Provider business mailing address

3629 W 29TH AVE
DENVER CO
80211-3601
US

V. Phone/Fax

Practice location:
  • Phone: 303-433-7221
  • Fax: 303-477-0519
Mailing address:
  • Phone: 303-433-7221
  • Fax: 303-477-0519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: DIANA L HARRIS
Title or Position: RESIDENT ACCTS BOOK KEEPER
Credential:
Phone: 303-433-7221