Healthcare Provider Details

I. General information

NPI: 1811337926
Provider Name (Legal Business Name): OUTPATIENT SURGICAL RECOVERY SUITES OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2013
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9777 S YOSEMITE ST SUITE 220
LONE TREE CO
80124-3191
US

IV. Provider business mailing address

2779 W HORIZON RIDGE PKWY SUITE 200
HENDERSON NV
89052-4184
US

V. Phone/Fax

Practice location:
  • Phone: 702-990-2290
  • Fax: 702-932-8377
Mailing address:
  • Phone: 702-990-2290
  • Fax: 702-932-8377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHEAL JAMES CROVETTI JR.
Title or Position: OWNER/PRESIDENT
Credential: D.O.
Phone: 702-990-2290