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General NPI Number Information
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NPI Number | 1043758527
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Entity Type | Organization
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Legal Business Name | SENIORS' RESOURCE CENTER, INC. EVERGREEN
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | 5120 HIGHWAY 73
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City | EVERGREEN
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State | CO
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Zip | 80439-7301
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Country | US
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Telephone | 303-674-2843
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Fax | 303-674-8874
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Provider Business Mailing Address
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Address Line | 3227 CHASE ST
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City | WHEAT RIDGE
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State | CO
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Zip | 80212-7033
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Country | US
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Telephone | 303-238-8151
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Fax | 303-238-4393
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JOHN ZABAWA
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Credential |
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Telephone | 303-238-8151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 04G940
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License Number State | CO
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