1467864306 NPI number — JEWELL ASSISTED LIVING MANAGEMENT INC

Table of content: (NPI 1467864306)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467864306 NPI number — JEWELL ASSISTED LIVING MANAGEMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEWELL ASSISTED LIVING MANAGEMENT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467864306
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 LOWELL BLVD
Provider Second Line Business Mailing Address:
#111
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80204-1545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-893-9300
Provider Business Mailing Address Fax Number:
303-893-4384

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 LOWELL BLVD
Provider Second Line Business Practice Location Address:
#111
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80204-1545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-893-9300
Provider Business Practice Location Address Fax Number:
303-893-4384
Provider Enumeration Date:
05/27/2014

Additional Information

Authorized Official

Authorized Official Last Name:
ROSSIE
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
303-893-9300

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  2304JQ , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com