Provider Demographics
NPI:1528204963
Name:FOREST STREET COMPASSIONATE CARE
Entity Type:Organization
Organization Name:FOREST STREET COMPASSIONATE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:OYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-929-0086
Mailing Address - Street 1:5091 KIPLING
Mailing Address - Street 2:ST # 330-313
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033
Mailing Address - Country:US
Mailing Address - Phone:303-393-7600
Mailing Address - Fax:303-393-7606
Practice Address - Street 1:3345 FOREST ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207
Practice Address - Country:US
Practice Address - Phone:720-929-0086
Practice Address - Fax:720-519-0236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0083314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96578564Medicaid
CO96578564Medicaid