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General NPI Number Information
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NPI Number | 1619425881
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Entity Type | Organization
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Legal Business Name | THE RISING SUN SENIOR HOME INC.
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 421 S FENTON ST
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City | LAKEWOOD
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State | CO
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Zip | 80226-3556
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Country | US
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Telephone | 303-937-3473
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Fax |
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Provider Business Mailing Address
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Address Line | 421 S FENTON ST
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City | LAKEWOOD
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State | CO
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Zip | 80226-3556
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CORPORATE OFFICE
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Name | NANA BOGYAH
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Credential |
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Telephone | 303-937-3473
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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 | 23F110
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License Number State | CO
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