South Marion Manor Cares LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SOUTH MARION MANOR CARES LLC

Practice address

8089 S Marion Cir
Centennial, CO 80122-2929

Phone

(303) 834-5646

NPI assigned

May 25, 2021

Organization subpart

No

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

Authorized official

Name

Mark Radlauer

Title

Member

Phone

(303) 834-5646

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1982279659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270523",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800275008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8089 S MARION CIR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801222929",
            "telephone_number": "303-834-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MARION MANOR CARES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "RADLAUER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "303-834-5646"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2304C8",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fax",
            "affiliation": "N",
            "endpointDescription": "Secure fax",
            "address_1": "8089 S Marion Cir",
            "city": "Centennial",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801222929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Assisted Living Facility in Centennial, CO
• Providers in Centennial, CO by specialty
• Assisted Living Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.