Organization Active NPI

Campbell-Muljanah Enterprises

  • Assisted Living Facility
  • Centennial, CO
National Provider Identifier
1124325014
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
23Q703 Issued in CO
Legal business name
CAMPBELL-MULJANAH ENTERPRISES
Practice address
4468 E Lake Cir S
Centennial, CO 80121-3314
Phone
(303) 694-5743
Fax
(303) 694-5743
NPI assigned
Feb 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Lyle Campbell
Title
Administrator
Phone
(303) 941-9460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 23Q703 CO Primary

Addresses

Primary practice location

4468 E Lake Cir S
Centennial, CO 80121-3314

Mailing address

4953 S Field CT
Littleton, CO 80123-1919
Phone (303) 941-9460

Other identifiers 1

IdentifierTypeStateIssuer
COTP139457AMedicaidCO

Other names 1

  • St. Bernadette Assisted Living Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1124325014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4953 S FIELD CT",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801231919",
            "telephone_number": "303-941-9460",
            "fax_number": "303-694-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4468 E LAKE CIR S",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801213314",
            "telephone_number": "303-694-5743",
            "fax_number": "303-694-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL-MULJANAH ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-11",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "LYLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "303-941-9460",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23Q703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "COTP139457A",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Bernadette Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.