Provider Demographics
NPI:1588412696
Name:LODGE PALMER POINT, LLC
Entity type:Organization
Organization Name:LODGE PALMER POINT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-329-1200
Mailing Address - Street 1:3205 LESLIE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1039
Mailing Address - Country:US
Mailing Address - Phone:719-329-1200
Mailing Address - Fax:719-329-1203
Practice Address - Street 1:3205 LESLIE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1039
Practice Address - Country:US
Practice Address - Phone:719-329-1200
Practice Address - Fax:719-329-1203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility