Healthcare Provider Details

I. General information

NPI: 1235851221
Provider Name (Legal Business Name): FOREST STREET LTC, LLLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3345 FOREST ST
DENVER CO
80207-1944
US

IV. Provider business mailing address

3440 YOUNGFIELD ST # 358
WHEAT RIDGE CO
80033-5245
US

V. Phone/Fax

Practice location:
  • Phone: 303-393-7600
  • Fax: 303-393-7606
Mailing address:
  • Phone: 720-929-0086
  • Fax: 720-929-0381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MITCHELL FRIEDMAN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 720-929-0086