Organization
LONGMONT TC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PAUL TAYLOR (AUTHORIZED OFFICIAL)
(972) 899-4401
Entity
Organization
Contact information
Practice address
1960 SOUTH FORDHAM ST, LONGMONT, CO 80503
(972) 899-4401
(972) 899-4806
Mailing address
1500 WATERS RIDGE DR, LEWISVILLE, TX 75057-6011
(972) 899-4401
(972) 899-4806
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/11/2017
Last updated
09/30/2021
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