Organization
MADISON SENIOR LIVING MANAGEMENT LLC
Active
Parent organization
MADISON SENIOR LIVING MANAGEMENT LLC
Other names
Grace Manor Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MADISON SENIOR LIVING MANAGEMENT LLC
Authorized official
GARY LANGENDOEN (OWNER)
(303) 952-9216
Entity
Organization
Contact information
Practice address
465 5TH ST, BURLINGTON, CO 80807-1932
(719) 346-7512
Mailing address
2668 NORTHPARK DR, LAFAYETTE, CO 80026-3199
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95534741
—
CO
Enumeration date
08/17/2021
Last updated
08/17/2021
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