Provider Demographics
NPI:1811623861
Name:ELMUGTABAS ASSISTED LIVING
Entity Type:Organization
Organization Name:ELMUGTABAS ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMUGTABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-421-8258
Mailing Address - Street 1:1200 S MONACO PKWY UNIT 9
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1892
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 S MONACO PKWY UNIT 9
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1892
Practice Address - Country:US
Practice Address - Phone:720-421-8258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare