Provider Demographics
NPI:1437356425
Name:THE MANOR ON ORCHARD RD, LLC
Entity Type:Organization
Organization Name:THE MANOR ON ORCHARD RD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:ROPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-932-9808
Mailing Address - Street 1:4800 OLD S. WADSWORTH BLVD.
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1134
Mailing Address - Country:US
Mailing Address - Phone:303-932-9808
Mailing Address - Fax:720-981-1996
Practice Address - Street 1:290 E ORCHARD RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-1134
Practice Address - Country:US
Practice Address - Phone:303-932-9808
Practice Address - Fax:720-981-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO55523277Medicaid