Organization
MADISON SENIOR LIVING MANAGEMENT LLC
Active
Other names
Grace Manor Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN KIKLIS (CFO)
(303) 952-9216
Entity
Organization
Contact information
Practice address
465 5TH STREET, BURLINGTON, CO 80807
(719) 346-7512
(719) 346-9373
Mailing address
465 5TH STREET, BURLINGTON, CO 80807
(719) 346-7512
(719) 346-9373
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12601748
—
CO
Enumeration date
06/12/2013
Last updated
07/27/2021
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