Healthcare Provider Details

I. General information

NPI: 1407215429
Provider Name (Legal Business Name): MAIRIK ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7255 S HAVANA ST STE 130
CENTENNIAL CO
80112-3887
US

IV. Provider business mailing address

7255 S HAVANA ST STE 130
CENTENNIAL CO
80112-3887
US

V. Phone/Fax

Practice location:
  • Phone: 303-960-4732
  • Fax: 303-736-2195
Mailing address:
  • Phone: 303-960-4732
  • Fax: 303-736-2195

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: ARTEM MATEVOSYANTS
Title or Position: CONTROLLER
Credential:
Phone: 303-960-4732