NPIMap

Organization Active NPI

Haven of Care Assisted Living at Tollgate Crossing

  • Assisted Living Facility
  • Aurora, CO
National Provider Identifier
1912299785
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
23D456 Issued in CO
Legal business name
HAVEN OF CARE ASSISTED LIVING AT TOLLGATE CROSSING
Practice address
5010 S Duquesne St
Aurora, CO 80016-5866
Phone
(303) 947-7392
Fax
(303) 400-5159
NPI assigned
May 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Authorized official

Name
Ms. Megawati Wirantono
Title
Owner/Administrator
Phone
(303) 947-7392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 23D456 CO Primary

Addresses

Primary practice location

5010 S Duquesne St
Aurora, CO 80016-5866

Mailing address

PO Box 461284
Centennial, CO 80046-1284
Phone (303) 690-5534

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1912299785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 461284",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800461284",
            "telephone_number": "303-690-5534",
            "fax_number": "303-400-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 S DUQUESNE ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165866",
            "telephone_number": "303-947-7392",
            "fax_number": "303-400-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN OF CARE ASSISTED LIVING AT TOLLGATE CROSSING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "WIRANTONO",
        "authorized_official_first_name": "MEGAWATI",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "303-947-7392",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CO",
            "license": "23D456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.