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General NPI Number Information
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NPI Number | 1275957151
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Entity Type | Organization
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Legal Business Name | EVERETT COURT OPERATIONS, LLC
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 1320 EVERETT CT
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City | LAKEWOOD
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State | CO
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Zip | 80215-4830
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Country | US
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Telephone | 720-491-1934
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Fax | 866-924-5211
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Provider Business Mailing Address
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Address Line | 1320 EVERETT CT
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City | LAKEWOOD
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State | CO
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Zip | 80215-4830
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Country | US
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Telephone | 720-491-1934
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Fax | 866-924-5211
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Authorized Official
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Title or Position | AUTHORIZED MEMBER
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Name | LAWRENCE CALE WESTER
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Credential |
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Telephone | 707-326-0623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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