Provider Demographics
NPI:1033855234
Name:WELLSPRING BRIGHTON ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:WELLSPRING BRIGHTON ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-272-7748
Mailing Address - Street 1:11726 ZENOBIA LOOP
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7851
Mailing Address - Country:US
Mailing Address - Phone:720-272-7748
Mailing Address - Fax:
Practice Address - Street 1:422 SUNSHINE WAY
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4289
Practice Address - Country:US
Practice Address - Phone:720-272-7748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23A842OtherCDPHE