Organization
PALISADES I MSL LLC
Active
Parent organization
MBK SENIOR LIVING
Organization subpart
Yes
Provider details
NPI number
Legal business name
MBK SENIOR LIVING
Authorized official
MR. TERRY HINES HOWARD (PRESIDENT)
(949) 242-1410
Entity
Organization
Contact information
Practice address
4547 PALISADES PARK VW, COLORADO SPRINGS, CO 80906-8697
(719) 226-2273
Mailing address
4 PARK PLZ STE 500, IRVINE, CA 92614-5209
(949) 242-1414
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
23U762
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407143423
—
UT
05
—
1568759488
—
UT
05
—
1578850590
—
UT
Enumeration date
09/24/2012
Last updated
09/24/2012
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