Provider Demographics
NPI:1306327978
Name:WILLIAM JAMES WAKE INC
Entity type:Organization
Organization Name:WILLIAM JAMES WAKE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WAKE
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATION
Authorized Official - Phone:720-435-7690
Mailing Address - Street 1:7550 E 53RD PL UNIT 17848
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-7471
Mailing Address - Country:US
Mailing Address - Phone:720-435-7690
Mailing Address - Fax:
Practice Address - Street 1:13107 E EXPOSITION DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3526
Practice Address - Country:US
Practice Address - Phone:720-435-7690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health