NPI 1033381066

Robert Russell Eastern Star Masonic Center

Organisation Assisted Living Facility Denver, CO

Practice location

Address: 2445 S Quebec St, Denver, CO 80231-6030
Phone: (303) 753-2172

Authorised official

Name: Matthew Wistreich
Title: Executive Director
Phone: (303) 753-2174

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 2304HP (CO)

Other Assisted Living Facility providers in Colorado →

Registry record

NPI: 1033381066
Entity type: Organization
NPI issued: 31 Mar 2008
Record last updated: 31 Mar 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.