Healthcare Provider Details

I. General information

NPI: 1124091020
Provider Name (Legal Business Name): MONACO ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 E TENNESSEE AVE # 175
DENVER CO
80224-1628
US

IV. Provider business mailing address

6825 E TENNESSEE AVE # 175
DENVER CO
80224-1628
US

V. Phone/Fax

Practice location:
  • Phone: 303-333-2299
  • Fax: 303-388-3119
Mailing address:
  • Phone: 303-333-2299
  • Fax: 303-388-3119

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: MR. MARINA AYZENZON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-333-2299