Healthcare Provider Details

I. General information

NPI: 1932863602
Provider Name (Legal Business Name): EVEREST ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12201 E MISSISSIPPI AVE UNIT 101
AURORA CO
80012-3468
US

IV. Provider business mailing address

12201 E MISSISSIPPI AVE UNIT 101
AURORA CO
80012-3468
US

V. Phone/Fax

Practice location:
  • Phone: 720-612-7854
  • Fax: 720-612-7857
Mailing address:
  • Phone: 720-612-7854
  • Fax: 720-612-7857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SOM BARAL
Title or Position: ADMINISTRATOR
Credential:
Phone: 720-612-7854