Provider Demographics
NPI:1457008575
Name:LAFAYETTE SENIOR LIVING OPCO LLC
Entity Type:Organization
Organization Name:LAFAYETTE SENIOR LIVING OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-412-4005
Mailing Address - Street 1:225 WANEKA PKWY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8862
Mailing Address - Country:US
Mailing Address - Phone:303-666-0691
Mailing Address - Fax:
Practice Address - Street 1:225 WANEKA PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8862
Practice Address - Country:US
Practice Address - Phone:303-666-0691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility