Provider Demographics
NPI:1609450303
Name:JOGAN HEALTH, LLC
Entity Type:Organization
Organization Name:JOGAN HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIETRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-374-4988
Mailing Address - Street 1:204 GREEN VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8734
Mailing Address - Country:US
Mailing Address - Phone:303-374-4988
Mailing Address - Fax:
Practice Address - Street 1:204 GREEN VALLEY CIR
Practice Address - Street 2:
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108-8734
Practice Address - Country:US
Practice Address - Phone:303-374-4988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No251K00000XAgenciesPublic Health or Welfare