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General NPI Number Information
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NPI Number | 1881659332
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Entity Type | Organization
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Legal Business Name | SENIOR LIVING OF LAKEWOOD, LLC
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12791 W ALAMEDA PKWY
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City | LAKEWOOD
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State | CO
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Zip | 80228-2857
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Country | US
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Telephone | 303-237-5700
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Fax | 303-237-5850
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Provider Business Mailing Address
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Address Line | 7900 WESTPARK DR T-900 ATTN: MEDICARE BILLING, M. GARCIA
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City | MC LEAN
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State | VA
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Zip | 22102-4242
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Country | US
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Telephone | 703-854-0823
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Fax | 703-854-0164
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JUNE RICHARD
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Credential |
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Telephone | 303-237-5700
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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 | 0878
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License Number State | CO
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