Organization
BEEWELL ASSISTED LIVING LLC
Active
Organization
BEEWELL ASSISTED LIVING LLC
Active
Other names
BeeWell Assisted Living LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON SCOTT GUSTAFSON MBA/MHA (MANAGING MEMBER)
(801) 696-7587
Entity
Organization
Contact information
Practice address
816 W KIOWA ST, COLORADO SPRINGS, CO 80905-1423
(719) 578-1355
(719) 578-5889
Mailing address
8007 S 6910 W, WEST JORDAN, UT 84081-3117
(801) 696-7587
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230508
STATE OF COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
CO
Enumeration date
12/29/2020
Last updated
12/29/2020
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