Provider Demographics
NPI:1023388352
Name:THOMAS JEFFERSON DAY CENTER
Entity Type:Organization
Organization Name:THOMAS JEFFERSON DAY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-982-5732
Mailing Address - Street 1:5922 S BIRCH WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-3369
Mailing Address - Country:US
Mailing Address - Phone:720-982-5732
Mailing Address - Fax:303-200-8437
Practice Address - Street 1:5922 S BIRCH WAY
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-3369
Practice Address - Country:US
Practice Address - Phone:720-982-5732
Practice Address - Fax:303-200-8437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO922447943347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle