Provider Demographics
NPI:1578012845
Name:SITES, JANICE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:SITES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 330094
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-8094
Mailing Address - Country:US
Mailing Address - Phone:303-358-4004
Mailing Address - Fax:866-810-7263
Practice Address - Street 1:1882 E 104TH AVE UNIT 423
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-4324
Practice Address - Country:US
Practice Address - Phone:303-358-4004
Practice Address - Fax:866-810-7263
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO81451253253Z00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO81451253Medicaid