Provider Demographics
NPI:1073401469
Name:A DEMENTIA JOURNEY
Entity type:Organization
Organization Name:A DEMENTIA JOURNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:GREENSTREET
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-251-2568
Mailing Address - Street 1:49200 W US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-9748
Mailing Address - Country:US
Mailing Address - Phone:719-251-2568
Mailing Address - Fax:877-752-2076
Practice Address - Street 1:49200 W US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-9748
Practice Address - Country:US
Practice Address - Phone:719-251-2568
Practice Address - Fax:877-752-2076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty