Healthcare Provider Details

I. General information

NPI: 1114148335
Provider Name (Legal Business Name): MARION DOWNS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 01/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4280 HALE PARKWAY
DENVER CO
80220
US

IV. Provider business mailing address

4280 HALE PARKWAY
DENVER CO
80220
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-1871
  • Fax: 303-399-3411
Mailing address:
  • Phone: 303-322-1871
  • Fax: 303-399-3411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JILL C WAYNE
Title or Position: EXECUTIVE DIRECTOR
Credential: MA CCC A
Phone: 303-322-1871