Healthcare Provider Details

I. General information

NPI: 1386801017
Provider Name (Legal Business Name): SKY CLIFF STROKE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 06/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 HIGHWAY 86
CASTLE ROCK CO
80104
US

IV. Provider business mailing address

4600 E HIGHWAY 86
CASTLE ROCK CO
80104
US

V. Phone/Fax

Practice location:
  • Phone: 303-814-2863
  • Fax: 303-814-2863
Mailing address:
  • Phone: 303-814-2863
  • Fax: 303-814-2863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL LEE NOVAK
Title or Position: TREASURER
Credential:
Phone: 303-875-3597