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General NPI Number Information
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NPI Number | 1619462660
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Entity Type | Organization
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Legal Business Name | THE CHATEAUS, LLC, D/B/A COLUMBINE CHATEAU
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 720 E SPRINGMONT DR
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City | PUEBLO
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State | CO
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Zip | 81007-3526
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Country | US
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Telephone | 719-566-1185
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Fax | 719-582-1326
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Provider Business Mailing Address
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Address Line | 720 E SPRINGMONT DR
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City | PUEBLO
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State | CO
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Zip | 81007-3526
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Country | US
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Telephone | 719-566-1185
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Fax | 719-582-1326
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Authorized Official
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Title or Position | OWNER
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Name | CHERY LUCERO
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Credential |
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Telephone | 719-566-1185
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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 | 23D501
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License Number State | CO
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