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Organization

WINSLOW COURT COCSWC, LLC

Active
Parent organization
STELLAR SENIOR LIVING LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
STELLAR SENIOR LIVING LLC
Authorized official
MR. EVRETT BENTON (PRESIDENT)
(801) 859-5126
Entity
Organization

Contact information

Practice address
3920 E SAN MIGUEL ST, COLORADO SPRINGS, CO 80909-3427
(719) 597-1700
(719) 574-6074
Mailing address
3920 E SAN MIGUEL ST, COLORADO SPRINGS, CO 80909-3427
(719) 597-1700
(719) 574-6074

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
230512
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
230512
PROVIDER LICENSE NUMBER
CO
Enumeration date
07/06/2012
Last updated
07/06/2012
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