Provider Demographics
NPI:1144750365
Name:PARKER PERSONAL CARE HOMES, INC.
Entity Type:Organization
Organization Name:PARKER PERSONAL CARE HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-424-6078
Mailing Address - Street 1:1597 COLE BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3417
Mailing Address - Country:US
Mailing Address - Phone:303-424-6078
Mailing Address - Fax:
Practice Address - Street 1:5555 HARLAN ST
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2731
Practice Address - Country:US
Practice Address - Phone:303-424-6078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO97633241Medicaid