Provider Demographics
NPI:1396341939
Name:SOLANGE AT EVENINGSONG LLC
Entity type:Organization
Organization Name:SOLANGE AT EVENINGSONG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-231-2152
Mailing Address - Street 1:572 EVENINGSONG DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2903
Mailing Address - Country:US
Mailing Address - Phone:719-231-2152
Mailing Address - Fax:
Practice Address - Street 1:572 EVENINGSONG DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2903
Practice Address - Country:US
Practice Address - Phone:719-231-2152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility