Healthcare Provider Details

I. General information

NPI: 1568026490
Provider Name (Legal Business Name): NJZ MEMORY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 E GEDDES AVE STE 50
ENGLEWOOD CO
80112-9306
US

IV. Provider business mailing address

9800 E GEDDES AVE STE 50
ENGLEWOOD CO
80112-9306
US

V. Phone/Fax

Practice location:
  • Phone: 720-405-6043
  • Fax:
Mailing address:
  • Phone: 720-405-6043
  • Fax:

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: MIRANDA HUERTA
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 720-405-6047