Provider Demographics
NPI:1942667118
Name:PALISADE HEALTH, LLC
Entity Type:Organization
Organization Name:PALISADE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM ACP
Authorized Official - Phone:303-956-9035
Mailing Address - Street 1:21933 E RIDGE TRAIL CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2665
Mailing Address - Country:US
Mailing Address - Phone:303-956-9035
Mailing Address - Fax:
Practice Address - Street 1:21933 E RIDGE TRAIL CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-2665
Practice Address - Country:US
Practice Address - Phone:303-956-9035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty