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General NPI Number Information
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NPI Number | 1700600913
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Entity Type | Organization
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Legal Business Name | GARDENS CARE HOMESTEAD
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 2121 WADSWORTH BLVD
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City | LAKEWOOD
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State | CO
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Zip | 80214-5706
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Country | US
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Telephone | 303-221-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 12650 W 64TH AVE # E172
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City | ARVADA
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State | CO
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Zip | 80004-3893
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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 | OWNER
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Name | JENNIFER CONRAD
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Credential |
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Telephone | 303-421-6539
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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 |
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License Number State |
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