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General NPI Number Information
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NPI Number | 1306327978
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Entity Type | Organization
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Legal Business Name | WILLIAM JAMES WAKE INC
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 13107 E EXPOSITION DR
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City | AURORA
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State | CO
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Zip | 80012-3526
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Country | US
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Telephone | 720-435-7690
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Fax |
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Provider Business Mailing Address
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Address Line | 7550 E 53RD PL UNIT 17848
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City | DENVER
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State | CO
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Zip | 80217-7471
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Country | US
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Telephone | 720-435-7690
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ C.E.O.
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Name | MR. WILLIAM JAMES WAKE
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Credential | ADMINISTRATION
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Telephone | 720-435-7690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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