Healthcare Provider Details

I. General information

NPI: 1710346606
Provider Name (Legal Business Name): SUMMIT ADULT DAY & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2016
Last Update Date: 02/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9032 W KEN CARYL AVE SUITE A-1
LITTLETON CO
80128-9330
US

IV. Provider business mailing address

2855 ROCK CREEK CIR UNIT 112
SUPERIOR CO
80027-4612
US

V. Phone/Fax

Practice location:
  • Phone: 303-834-5646
  • Fax:
Mailing address:
  • Phone: 303-834-5646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateCO

VIII. Authorized Official

Name: CHIRAG SHAH
Title or Position: MEMBER
Credential:
Phone: 303-834-5646