Provider Demographics
NPI:1528594710
Name:DEDIKAS COMMUNITY ALTERNATIVES, INC
Entity Type:Organization
Organization Name:DEDIKAS COMMUNITY ALTERNATIVES, INC
Other - Org Name:DCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOED
Authorized Official - Middle Name:
Authorized Official - Last Name:EMILE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-429-4458
Mailing Address - Street 1:19609 E 47TH DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-6840
Mailing Address - Country:US
Mailing Address - Phone:720-429-4458
Mailing Address - Fax:
Practice Address - Street 1:19609 E 47TH DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-6840
Practice Address - Country:US
Practice Address - Phone:720-429-4458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-07
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health