Provider Demographics
NPI:1215480926
Name:SUMMIT ADULT DAY AND WELLNESS
Entity type:Organization
Organization Name:SUMMIT ADULT DAY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-922-0100
Mailing Address - Street 1:9032 W KEN CARYL AVE STE A-1
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-5251
Mailing Address - Country:US
Mailing Address - Phone:720-922-0100
Mailing Address - Fax:720-922-0101
Practice Address - Street 1:9032 W KEN CARYL AVE STE A-1
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-5251
Practice Address - Country:US
Practice Address - Phone:720-922-0100
Practice Address - Fax:720-922-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO22921877Medicaid