Provider Demographics
NPI:1366689085
Name:CHATEAU JULIA HEALTHCARE, INC.
Entity Type:Organization
Organization Name:CHATEAU JULIA HEALTHCARE, INC.
Other - Org Name:JULIA TEMPLE HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-540-1249
Mailing Address - Street 1:3401 S LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2926
Mailing Address - Country:US
Mailing Address - Phone:303-761-0075
Mailing Address - Fax:303-761-2967
Practice Address - Street 1:3401 S LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2926
Practice Address - Country:US
Practice Address - Phone:303-761-0075
Practice Address - Fax:303-761-2967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO065322Medicare Oscar/Certification