Provider Demographics
NPI:1326628371
Name:EQC SILVER ROSE INCORPORATED
Entity Type:Organization
Organization Name:EQC SILVER ROSE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALMAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-456-9246
Mailing Address - Street 1:5420 FIELD CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-3040
Mailing Address - Country:US
Mailing Address - Phone:303-420-4295
Mailing Address - Fax:303-420-4272
Practice Address - Street 1:5420 FIELD CT
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-3040
Practice Address - Country:US
Practice Address - Phone:303-420-4295
Practice Address - Fax:303-420-4272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO2403MLMedicaid