Organization
CONSTITUTION ROAD HEALTHCARE, INC.
Active
Other names
Julia Temple Outpatient Services
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (TREASURER)
(949) 540-1249
Entity
Organization
Contact information
Practice address
3401 S LAFAYETTE ST, ENGLEWOOD, CO 80113-2926
(303) 761-0075
(303) 761-2967
Mailing address
27101 PUERTA REAL STE 450, MISSION VIEJO, CA 92691-8566
(949) 540-1249
(949) 540-1966
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
09/01/2017
Last updated
03/10/2022
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