Healthcare Provider Details

I. General information

NPI: 1700325057
Provider Name (Legal Business Name): CENTER AT EDEN HILL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BANNING STREET
DOVER DE
19904
US

IV. Provider business mailing address

3490 CENTENNIAL BLVD
COLORADO SPRINGS CO
80907-4087
US

V. Phone/Fax

Practice location:
  • Phone: 719-685-8888
  • Fax: 719-685-8958
Mailing address:
  • Phone: 719-685-8888
  • Fax: 719-685-8958

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: JULIE KELLY
Title or Position: OPERATIONS ASSISTANT
Credential:
Phone: 719-685-8951