Provider Demographics
NPI:1437574514
Name:GREEN MEADOWS ASSISTED LIVING
Entity Type:Organization
Organization Name:GREEN MEADOWS ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-585-8143
Mailing Address - Street 1:2177 S GOLDEN CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3606
Mailing Address - Country:US
Mailing Address - Phone:303-955-0026
Mailing Address - Fax:303-955-0026
Practice Address - Street 1:2177 S GOLDEN CT
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227-3606
Practice Address - Country:US
Practice Address - Phone:303-955-0026
Practice Address - Fax:303-955-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23Q902310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility