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Organization

HAVEN OF CARE ASSISTED LIVING AT TOLLGATE CROSSING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MEGAWATI WIRANTONO (OWNER/ADMINISTRATOR)
(303) 947-7392
Entity
Organization

Contact information

Practice address
5010 S DUQUESNE ST, AURORA, CO 80016-5866
(303) 947-7392
(303) 400-5159
Mailing address
PO BOX 461284, CENTENNIAL, CO 80046-1284
(303) 690-5534
(303) 400-5159

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
23D456
CO

Other

Enumeration date
05/11/2011
Last updated
05/11/2011
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