Provider Demographics
NPI:1811337926
Name:OUTPATIENT SURGICAL RECOVERY SUITES OF COLORADO
Entity type:Organization
Organization Name:OUTPATIENT SURGICAL RECOVERY SUITES OF COLORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CROVETTI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:702-990-2290
Mailing Address - Street 1:2779 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4184
Mailing Address - Country:US
Mailing Address - Phone:702-990-2290
Mailing Address - Fax:702-932-8377
Practice Address - Street 1:9777 S YOSEMITE ST
Practice Address - Street 2:SUITE 220
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-3191
Practice Address - Country:US
Practice Address - Phone:702-990-2290
Practice Address - Fax:702-932-8377
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORONADO SURGICAL LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility