Healthcare Provider Details

I. General information

NPI: 1932681335
Provider Name (Legal Business Name): DESHANO CARE CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2018
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 S REED CT
LAKEWOOD CO
80227-5216
US

IV. Provider business mailing address

355 S TELLER ST STE 200
LAKEWOOD CO
80226-7391
US

V. Phone/Fax

Practice location:
  • Phone: 303-803-6977
  • Fax:
Mailing address:
  • Phone: 303-803-6977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number2304KB
License Number StateCO

VIII. Authorized Official

Name: SUKONTAR DESHANO
Title or Position: OWNER
Credential:
Phone: 303-803-6977