# CONSTITUTION ROAD HEALTHCARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Julia Temple Outpatient Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740708429
- **Authorized official:** SOON BURNAM (TREASURER)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 3401 S LAFAYETTE ST, ENGLEWOOD, CO 80113-2926
- **Practice address phone:** (303) 761-0075
- **Practice address fax:** (303) 761-2967
- **Mailing address:** 27101 PUERTA REAL STE 450, MISSION VIEJO, CA 92691-8566
- **Mailing address phone:** (949) 540-1249
- **Mailing address fax:** (949) 540-1966

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |

## Other

- **Enumeration date:** 09/01/2017
- **Last updated:** 03/10/2022