Organization
SOUTH MARION MANOR CARES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RADLAUER (MEMBER)
(303) 834-5646
Entity
Organization
Contact information
Practice address
8089 S MARION CIR, CENTENNIAL, CO 80122-2929
(303) 834-5646
Mailing address
PO BOX 270523, LOUISVILLE, CO 80027-5008
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2304C8
—
CO
Enumeration date
05/25/2021
Last updated
05/25/2021
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