Basic Information
| Provider Information | |||||||||
| NPI: | 1184291932 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WASHINGTON ADVANCED CARE NETWORK, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3827 N LAFAYETTE ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802053339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035001518 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3827 N LAFAYETTE ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802053339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035001518 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2021 | ||||||||
| LastUpdateDate: | 06/09/2021 | ||||||||
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| AuthorizedOfficialLastName: | SCOTT | ||||||||
| AuthorizedOfficialFirstName: | CARRIE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT OF REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 7204808088 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | WASHINGTON ADVANCED CARE NETWORK, LLC | ||||||||
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| NPICertificationDate: | 05/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | Y | Agencies | Case Management |
No ID Information.