Provider Demographics
NPI:1679059745
Name:THE HOMESTEAD AT MONTROSE, INC.
Entity Type:Organization
Organization Name:THE HOMESTEAD AT MONTROSE, INC.
Other - Org Name:THE HOMESTEAD AT MONTROSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-983-4249
Mailing Address - Street 1:1819 PAVILION DR
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5769
Mailing Address - Country:US
Mailing Address - Phone:970-252-9359
Mailing Address - Fax:970-252-9358
Practice Address - Street 1:1819 PAVILION DR
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5769
Practice Address - Country:US
Practice Address - Phone:970-252-9359
Practice Address - Fax:970-252-9358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-12
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility