=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184402273
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALMOND TREE SENIOR CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2023
-----------------------------------------------------
Last Update Date | 09/19/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5310 W GEDDES AVE
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80128-4955
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-972-0827
-----------------------------------------------------
Fax | 303-979-4794
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7716 S HUDSON CT
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80122-3809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-999-7773
-----------------------------------------------------
Fax | 720-472-8645
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | SONIA IDNANI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 720-999-7773
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------