Provider Demographics
NPI:1043765084
Name:THE SENIOR HUB, INC
Entity Type:Organization
Organization Name:THE SENIOR HUB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CALINA
Authorized Official - Middle Name:CHATELAIN
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-426-4408
Mailing Address - Street 1:9025 GRANT ST STE 150
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4346
Mailing Address - Country:US
Mailing Address - Phone:303-426-4408
Mailing Address - Fax:303-426-0014
Practice Address - Street 1:2360 W 90TH AVE
Practice Address - Street 2:
Practice Address - City:FEDERAL HEIGHTS
Practice Address - State:CO
Practice Address - Zip Code:80260
Practice Address - Country:US
Practice Address - Phone:303-287-2400
Practice Address - Fax:303-287-0572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000143628Medicaid