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PUEBLO WEST ASSISTED LIVING LLC NPI 1649231648


NPI Information

NPI: 1649231648
Provider Name: PUEBLO WEST ASSISTED LIVING, LLC

Doing Business As: LEGACY COMMONS AT PUEBLO WEST

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
170 S DACONA DR
PUEBLO WEST, CO
ZIP 81007
Phone: (719) 547-2538
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PUEBLO WEST ASSISTED LIVING, LLC is an assisted living facility in Pueblo West, CO. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. PUEBLO WEST ASSISTED LIVING, LLC NPI is 1649231648. The provider is registered as an organization entity type.
The provider Is Doing Business As Legacy Commons At Pueblo West.

The provider's business location address is:

170 S DACONA DR
PUEBLO WEST, CO
ZIP 81007-403
Phone: (719) 547-2538
Fax: (719) 547-8294

The provider's authorized official is Donald Kanen .
The authorized official title is Cfo and has the following contact phone number (719) 589-2063.

The enumeration date for this NPI number is 3/29/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityAL-0546COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
104183257MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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