Healthcare Provider Details

I. General information

NPI: 1407274517
Provider Name (Legal Business Name): CHERRY HILLS HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2014
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3575 S WASHINGTON ST
ENGLEWOOD CO
80113-3807
US

IV. Provider business mailing address

3575 S WASHINGTON ST
ENGLEWOOD CO
80113-3807
US

V. Phone/Fax

Practice location:
  • Phone: 303-789-2265
  • Fax: 303-781-8808
Mailing address:
  • Phone: 303-789-2265
  • Fax: 303-781-8808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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