Provider Demographics
NPI:1174728786
Name:THE VERANDAS ASSISTED LIVING AT WHEAT RIDGE LLC
Entity type:Organization
Organization Name:THE VERANDAS ASSISTED LIVING AT WHEAT RIDGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-490-6969
Mailing Address - Street 1:11205 E FOLSOM POINT LN
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80116-9105
Mailing Address - Country:US
Mailing Address - Phone:720-490-6969
Mailing Address - Fax:303-660-3676
Practice Address - Street 1:9495 W 49TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2277
Practice Address - Country:US
Practice Address - Phone:303-940-9707
Practice Address - Fax:303-940-4733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAL-1048310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO03959562Medicaid