Provider Demographics
NPI:1790490894
Name:DENIZEN ENDEAVORS INC.
Entity Type:Organization
Organization Name:DENIZEN ENDEAVORS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-969-8961
Mailing Address - Street 1:4634 BAGWELL DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-5797
Mailing Address - Country:US
Mailing Address - Phone:706-969-8961
Mailing Address - Fax:
Practice Address - Street 1:250 JOHN W MORROW JR PKWY STE 115
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-8532
Practice Address - Country:US
Practice Address - Phone:678-862-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy