Provider Demographics
NPI:1568639755
Name:JUNIPER VILLAGE AT AURORA
Entity Type:Organization
Organization Name:JUNIPER VILLAGE AT AURORA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-241-6335
Mailing Address - Street 1:11901 E MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2809
Mailing Address - Country:US
Mailing Address - Phone:303-341-6335
Mailing Address - Fax:303-341-6340
Practice Address - Street 1:11901 E MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2809
Practice Address - Country:US
Practice Address - Phone:303-341-6335
Practice Address - Fax:303-341-6340
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JUNIPER COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2304S1311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)