# RANDOLPH ASSISTED LIVING LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093252298
- **Authorized official:** MONALISA RANDOLPH (OWNER ADMINISTRATOR)
- **Authorized official phone:** (719) 250-3048

## Contact information

- **Practice address:** 12974 E ELGIN DR, DENVER, CO 80239-4419
- **Practice address phone:** (719) 250-3048
- **Practice address fax:** (303) 375-0674
- **Mailing address:** 12974 E ELGIN DR, DENVER, CO 80239-4419
- **Mailing address phone:** (719) 250-3048
- **Mailing address fax:** (303) 375-0674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 372600000X | Adult Companion | 23Q662 | CO | Yes |

## Other

- **Enumeration date:** 01/25/2017
- **Last updated:** 01/25/2017