Organization Name: | SSC BERTHOUD OPERATING COMPANY LLC |
NPI Number: | 1326168287 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KELLE C SANTORO (SR DIRECTOR AR) |
Mailing Address: | 855 Franklin Ave Berthoud |
State: | CO US |
Postal Code: | 805131158 |
Phone Number: | 9705322683 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2007 |
NPI Last Update Date: | 04/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | 1284 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |