Provider Demographics
NPI:1700472388
Name:ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:SKYLAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-304-0448
Mailing Address - Street 1:PO BOX 440723
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80044-0723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2607 S EUDORA PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6124
Practice Address - Country:US
Practice Address - Phone:720-338-3606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZESTY ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility