Healthcare Provider Details
I. General information
NPI: 1285279851
Provider Name (Legal Business Name): W III, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/07/2019
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1655 EATON ST
LAKEWOOD CO
80214-1628
US
IV. Provider business mailing address
1127 E 16TH AVE
DENVER CO
80218-1506
US
V. Phone/Fax
- Phone: 303-238-5363
- Fax:
- Phone: 303-421-3600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MARK
BEDINGER
Title or Position: CEO/PRESIDENT
Credential:
Phone: 303-421-3600