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NPI Code Detail

MEDICARE: BIJOU HEALTHCARE LLC

MEDICARE: BIJOU HEALTHCARE 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 Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1020582OTHERCONURSING FACILITY LICENSE

General Provider Information

NPI Number : 1568907731
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIJOU HEALTHCARE LLC
Provider Business Mailing Address
First Line : 1719 EAST BIJOU STREET
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-5736
Country : US
Telephone Number : 719-381-4963
Fax Number : 719-381-4998
Provider Business Practice Location Address
First Line : 1719 E BIJOU ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-5736
Country : US
Telephone Number : 719-381-1000
Fax Number :
Authorized Official
Title or Position : TREASURER
Name : MRS. SOON BURNAM
Credential :
Telephone Number : 949-540-1249
Provider Enumeration Date : 12/27/2016
Last Update Date : 06/02/2022

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Directions to “BIJOU HEALTHCARE LLC ” Practice Location

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