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General NPI Number Information
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NPI Number | 1124091020
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Entity Type | Organization
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Legal Business Name | MONACO ADULT DAY CARE
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 6825 E TENNESSEE AVE # 175
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City | DENVER
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State | CO
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Zip | 80224-1628
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Country | US
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Telephone | 303-333-2299
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Fax | 303-388-3119
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Provider Business Mailing Address
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Address Line | 6825 E TENNESSEE AVE # 175
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City | DENVER
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State | CO
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Zip | 80224-1628
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Country | US
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Telephone | 303-333-2299
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Fax | 303-388-3119
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MARINA AYZENZON
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Credential |
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Telephone | 303-333-2299
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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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