Organization
EBEN EZER LUTHERAN CARE CENTER
Active
Parent organization
EBEN EZER LUTHERAN CARE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
EBEN EZER LUTHERAN CARE CENTER
Authorized official
LESLIE MASON (CFO)
(970) 842-2861
Entity
Organization
Contact information
Practice address
1910 EDISON ST, BRUSH, CO 80723-1743
(970) 842-2861
Mailing address
122 HOSPITAL RD, BRUSH, CO 80723-1702
(970) 842-2861
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04070330
—
CO
Enumeration date
05/15/2020
Last updated
05/15/2020
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