Provider Demographics
NPI:1164106746
Name:ALLEN, NAFTALINA (ADMINISTRATOR)
Entity Type:Individual
Prefix:
First Name:NAFTALINA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12311 E ARKANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4303
Mailing Address - Country:US
Mailing Address - Phone:720-325-9310
Mailing Address - Fax:303-368-8896
Practice Address - Street 1:12311 E ARKANSAS AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4303
Practice Address - Country:US
Practice Address - Phone:303-368-0888
Practice Address - Fax:303-368-8896
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23U630310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility