Basic Information
| Provider Information | |||||||||
| NPI: | 1881830966 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOHNSON ADULT DAY PROGRAM, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 E 9TH AVE | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802032903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038694664 | ||||||||
| FaxNumber: | 3038692917 | ||||||||
| Practice Location | |||||||||
| Address1: | 3444 S EMERSON ST | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801132834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037891519 | ||||||||
| FaxNumber: | 3037897642 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2008 | ||||||||
| LastUpdateDate: | 12/19/2008 | ||||||||
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| AuthorizedOfficialLastName: | IRONS | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | B. | ||||||||
| AuthorizedOfficialTitleorPosition: | TREASURER | ||||||||
| AuthorizedOfficialTelephone: | 7209746784 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA0600X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
No ID Information.