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General NPI Number Information
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NPI Number | 1700536307
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Entity Type | Organization
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Legal Business Name | MRSC CO ASPEN HOUSE MASTER TENANT, LLC
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 2212 E 11TH ST
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City | LOVELAND
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State | CO
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Zip | 80537-3231
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Country | US
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Telephone | 970-635-9800
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Fax | 970-667-2362
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Provider Business Mailing Address
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Address Line | 3452 E FOOTHILL BLVD STE 720
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City | PASADENA
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State | CA
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Zip | 91107-6031
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Country | US
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Telephone | 626-796-8700
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Fax | 626-568-1416
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Authorized Official
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Title or Position | MANAGER/COO
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Name | GARY LANGENDOEN
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Credential |
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Telephone | 310-283-2731
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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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