Provider Demographics
NPI:1235172099
Name:ARC DENVER MONACO LLC
Entity Type:Organization
Organization Name:ARC DENVER MONACO LLC
Other - Org Name:INNOVATIVE SENIOR CARE AT HERITAGE CLUB DENVER TECH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-2250
Mailing Address - Street 1:4901 S MONACO ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3428
Mailing Address - Country:US
Mailing Address - Phone:615-221-2250
Mailing Address - Fax:
Practice Address - Street 1:4901 S MONACO ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-3428
Practice Address - Country:US
Practice Address - Phone:615-221-2250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKDALE SENIOR LIVING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-13
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066639Medicare Oscar/Certification