Robert Russell Eastern Star Masonic Center

LBN: Robert Russell Eastern Star Masonic Center
Robert Russell Eastern Star Masonic Center is an health care organization with primary practice located at 2445 S Quebec St , Denver CO 80231-6030. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Robert Russell Eastern Star Masonic Center can be contacted via phone (303) 753-2172, or through Wistreich, Matthew via phone (303) 753-2174.

Contact Information

Primary practice address
2445 S Quebec St Denver CO 80231-6030
Phone: (303) 753-2172
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wistreich, Matthew
Phone: (303) 753-2174

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 2304HP Colorado

Profile Details

NPI number 1033381066
LBN Legal business name Robert Russell Eastern Star Masonic Center
DBA Doing business as
Authorized official Wistreich, Matthew
Entity Organization
Organization subpart 1 No
Enumeration date Mar 31st, 2008
Last updated Mar 31st, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1033381066 NPPES
Colorado MEDICAID 04183240

Popular Providers