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General NPI Number Information
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NPI Number | 1992422828
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Entity Type | Organization
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Legal Business Name | EAST SIDE ASSISTED LIVING LLC
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 1716 N READING AVE
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City | PUEBLO
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State | CO
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Zip | 81001-2862
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Country | US
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Telephone | 719-391-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 E PIKES PEAK AVE STE 3
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5862
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Country | US
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Telephone | 719-231-2152
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CHRISTEL AIME
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Credential |
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Telephone | 719-231-2152
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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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