Healthcare Provider Details

I. General information

NPI: 1003418419
Provider Name (Legal Business Name): WASHINGTON ADVANCED CARE NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 11/10/2020
Certification Date: 11/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3827 N LAFAYETTE ST
DENVER CO
80205-3339
US

IV. Provider business mailing address

3827 N LAFAYETTE ST
DENVER CO
80205-3339
US

V. Phone/Fax

Practice location:
  • Phone: 303-500-1518
  • Fax:
Mailing address:
  • Phone: 303-500-1518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: JANE FALK
Title or Position: SENIOR VICE PRESIDENT-OPS
Credential: MHA, BSN, RN
Phone: 816-560-8645