Provider Demographics
NPI:1447911011
Name:AMERITUS PROPERTY FUND DURANGO LLC
Entity type:Organization
Organization Name:AMERITUS PROPERTY FUND DURANGO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-251-6356
Mailing Address - Street 1:206 BROADWAY AVE S STE 460
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-7005
Mailing Address - Country:US
Mailing Address - Phone:507-361-3495
Mailing Address - Fax:
Practice Address - Street 1:25 SUNSHINE CT
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-6023
Practice Address - Country:US
Practice Address - Phone:970-385-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility