=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700240934
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LANA ADULT DAY CARE INC.,
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/13/2016
-----------------------------------------------------
Last Update Date | 04/13/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7808 CHERRY CK S DR 407
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80231-3218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-309-3953
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7808 CHERRY CK S DR 407
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80231-3218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-309-3953
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | ELINA ABRAMOVICH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 720-309-3953
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------