Provider Demographics
NPI:1225200058
Name:MONUMENT ASSISTED LIVING
Entity Type:Organization
Organization Name:MONUMENT ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ARAGON
Authorized Official - Last Name:TROTH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:970-618-0636
Mailing Address - Street 1:2194 MCKINLEY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81503-1139
Mailing Address - Country:US
Mailing Address - Phone:970-241-6562
Mailing Address - Fax:970-241-7494
Practice Address - Street 1:2194 MCKINLEY DR
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81503-1139
Practice Address - Country:US
Practice Address - Phone:970-241-6562
Practice Address - Fax:970-241-7494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility