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General NPI Number Information
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NPI Number | 1679913479
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Entity Type | Organization
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Legal Business Name | LOVELAND I MSL LLC
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 06/26/2013
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Provider Practice Location Address
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Address Line | 535 DOUGLAS AVE
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City | LOVELAND
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State | CO
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Zip | 80537-5380
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Country | US
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Telephone | 970-593-9800
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Fax | 970-593-9810
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Provider Business Mailing Address
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Address Line | 4 PARK PLZ SUITE 400
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City | IRVINE
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State | CA
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Zip | 92614-8560
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Country | US
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Telephone | 949-242-1414
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TERRY HINES HOWARD
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Credential |
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Telephone | 949-242-1410
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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 | 23E476
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License Number State | CO
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