Provider Demographics
NPI:1710673421
Name:ASPEN LEAF ASSISTED LIVING RESIDENCE - LIMON INC
Entity Type:Organization
Organization Name:ASPEN LEAF ASSISTED LIVING RESIDENCE - LIMON INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWANSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-906-1643
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:
Mailing Address - City:FLAGLER
Mailing Address - State:CO
Mailing Address - Zip Code:80815-0426
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2050 6TH ST
Practice Address - Street 2:
Practice Address - City:LIMON
Practice Address - State:CO
Practice Address - Zip Code:80828-2114
Practice Address - Country:US
Practice Address - Phone:719-775-9412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPEN LEAF ASSISTED LIVING RESIDENCE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility