Healthcare Provider Details

I. General information

NPI: 1366698664
Provider Name (Legal Business Name): ADULT CARE MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 DIXON ST STE 320
LAFAYETTE CO
80026-8830
US

IV. Provider business mailing address

1455 DIXON ST STE 320
LAFAYETTE CO
80026-8830
US

V. Phone/Fax

Practice location:
  • Phone: 303-439-7760
  • Fax: 720-293-9882
Mailing address:
  • Phone: 303-439-7760
  • Fax: 720-293-9882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JC LODGE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-439-7760