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NPI Code Detail

MEDICARE: QL-ALLISON CARE CENTER, LLC

MEDICARE: QL-ALLISON CARE CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility0633CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063410587
Entity Type Code : Organization
Provider Name (Legal Business Name) : QL-ALLISON CARE CENTER, LLC
Provider Business Mailing Address
First Line : 1660 ALLISON ST
Second Line :
City : LAKEWOOD
State : CO
Zip : 80214-6023
Country : US
Telephone Number : 303-232-7177
Fax Number : 303-232-0480
Provider Business Practice Location Address
First Line : 1660 ALLISON ST
Second Line :
City : LAKEWOOD
State : CO
Zip : 80214-6023
Country : US
Telephone Number : 303-232-7177
Fax Number : 303-232-0480
Authorized Official
Title or Position : CEO/MANAGING MEMBER
Name : MR. JAY H MOSKOWITZ
Credential : NHA
Telephone Number : 303-238-3838
Provider Enumeration Date : 07/08/2005
Last Update Date : 08/23/2007

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Directions to “QL-ALLISON CARE CENTER, LLC ” Practice Location

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