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General NPI Number Information
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NPI Number | 1205131877
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Entity Type | Organization
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Legal Business Name | ASPEN HILLS ASSISTED LIVING LLC
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 1030 JAY ST
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City | LAKEWOOD
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State | CO
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Zip | 80214-2016
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Country | US
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Telephone | 720-480-1326
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Fax |
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Provider Business Mailing Address
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Address Line | 4076 S CARSON WAY
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City | AURORA
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State | CO
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Zip | 80014-8101
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Country | US
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Telephone | 720-480-1326
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Fax |
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Authorized Official
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Title or Position | OWNER, ADMINISTRATOR
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Name | MS. VIKTORIA KLYACHKO
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Credential |
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Telephone | 720-480-1326
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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 | 23F112
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License Number State | CO
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