Provider Demographics
NPI:1720876469
Name:MADISON SENIOR LIVING MANAGEMENT LLC
Entity type:Organization
Organization Name:MADISON SENIOR LIVING MANAGEMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGENDOEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-796-8700
Mailing Address - Street 1:3452 E FOOTHILL BLVD STE 720
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-6031
Mailing Address - Country:US
Mailing Address - Phone:626-796-8700
Mailing Address - Fax:
Practice Address - Street 1:15 S ASH ST
Practice Address - Street 2:
Practice Address - City:KEENESBURG
Practice Address - State:CO
Practice Address - Zip Code:80643-5029
Practice Address - Country:US
Practice Address - Phone:303-732-4856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility