Healthcare Provider Details

I. General information

NPI: 1558110221
Provider Name (Legal Business Name): ORMAN RIDGE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 E ILIFF AVE
DENVER CO
80222-5721
US

IV. Provider business mailing address

6000 E ILIFF AVE
DENVER CO
80222-5721
US

V. Phone/Fax

Practice location:
  • Phone: 303-757-5441
  • Fax: 303-757-8862
Mailing address:
  • Phone: 303-757-5441
  • Fax: 303-757-8862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SOON BURNAM
Title or Position: TREASURER
Credential:
Phone: 949-540-1249