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General NPI Number Information
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NPI Number | 1649721374
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Entity Type | Organization
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Legal Business Name | DKL VENTURES, LLC
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 6143 S WILLOW DR STE 102
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-5122
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Country | US
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Telephone | 303-757-2300
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Fax | 303-756-3263
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Provider Business Mailing Address
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Address Line | 6143 S WILLOW DR STE 102
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-5122
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Country | US
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Telephone | 303-757-2300
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Fax | 303-756-3263
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AMANDA GODFREY
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Credential |
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Telephone | 303-757-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 04Y381
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License Number State | CO
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