Provider Demographics
NPI:1356076400
Name:CAWTHORN, ROZELLE
Entity Type:Individual
Prefix:
First Name:ROZELLE
Middle Name:
Last Name:CAWTHORN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25828 E CALHOUN PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-4399
Mailing Address - Country:US
Mailing Address - Phone:720-301-1369
Mailing Address - Fax:
Practice Address - Street 1:1605 WHITETAIL DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2809
Practice Address - Country:US
Practice Address - Phone:720-301-1369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances