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General NPI Number Information
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NPI Number | 1184380669
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Entity Type | Organization
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Legal Business Name | ASPIN WALL RESIDENTIAL ASSISTED LIVING LLC
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 8263 E MANSFIELD AVE
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City | DENVER
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State | CO
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Zip | 80237-1722
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Country | US
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Telephone | 720-422-9101
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 S PARKER RD STE 100
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City | DENVER
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State | CO
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Zip | 80231-7561
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Country | US
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Telephone | 720-422-9101
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERIC NELSON
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Credential |
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Telephone | 720-422-9101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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