Organization
BIRCH ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SUPIT (CO-OWNER)
(720) 296-0724
Entity
Organization
Contact information
Practice address
1819 BIRCH AVE, GREELEY, CO 80631-6142
(970) 346-1150
(970) 346-1151
Mailing address
1819 BIRCH AVE, GREELEY, CO 80631-6142
(720) 296-0724
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
23Y767
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23Y767
ASSISTED LIVING
CO
Enumeration date
05/10/2018
Last updated
05/10/2018
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