Healthcare Provider Details

I. General information

NPI: 1700536307
Provider Name (Legal Business Name): MRSC CO ASPEN HOUSE MASTER TENANT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2212 E 11TH ST
LOVELAND CO
80537-3231
US

IV. Provider business mailing address

3452 E FOOTHILL BLVD STE 720
PASADENA CA
91107-6031
US

V. Phone/Fax

Practice location:
  • Phone: 970-635-9800
  • Fax: 970-667-2362
Mailing address:
  • Phone: 626-796-8700
  • Fax: 626-568-1416

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: GARY LANGENDOEN
Title or Position: MANAGER/COO
Credential:
Phone: 310-283-2731