Healthcare Provider Details

I. General information

NPI: 1023015799
Provider Name (Legal Business Name): SANDALWOOD MANOR, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3835 HARLAN ST
WHEAT RIDGE CO
80033-5111
US

IV. Provider business mailing address

1667 SAINT PAUL ST
DENVER CO
80206-1614
US

V. Phone/Fax

Practice location:
  • Phone: 303-422-1533
  • Fax: 303-422-2433
Mailing address:
  • Phone: 303-421-3600
  • Fax: 303-388-1712

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: MR. RICHARD WHELAN
Title or Position: OWNER
Credential:
Phone: 303-422-1533