Provider Demographics
NPI:1346608072
Name:JUST FOR SENIORS LIVING CENTER
Entity Type:Organization
Organization Name:JUST FOR SENIORS LIVING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OTUKOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-238-6722
Mailing Address - Street 1:1450 WINONA CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204
Mailing Address - Country:US
Mailing Address - Phone:303-238-6722
Mailing Address - Fax:303-232-4095
Practice Address - Street 1:1180 BRENTWOOD ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-4015
Practice Address - Country:US
Practice Address - Phone:303-238-6722
Practice Address - Fax:303-232-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2304NE3104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04183513Medicaid