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General NPI Number Information
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NPI Number | 1972712792
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Entity Type | Organization
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Legal Business Name | PARK HILL RESIDENCE INC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 1901 EUDORA ST
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City | DENVER
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State | CO
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Zip | 80220-1252
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Country | US
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Telephone | 303-388-9437
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Fax | 303-370-1063
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Provider Business Mailing Address
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Address Line | 1510 17TH ST
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City | DENVER
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State | CO
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Zip | 80202-1202
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Country | US
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Telephone | 303-595-4464
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Fax | 303-595-9225
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MIKE HOLBROOK
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Credential |
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Telephone | 303-595-4464
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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 | AL-1039
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License Number State | CO
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