Provider Demographics
NPI:1962865881
Name:CASA DE ADULT DAY CARE INC
Entity Type:Organization
Organization Name:CASA DE ADULT DAY CARE INC
Other - Org Name:ABSOLUTE ADULT DAY PROGRAM INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-534-0321
Mailing Address - Street 1:12500 W 58TH AVE
Mailing Address - Street 2:UNIT 103
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1103
Mailing Address - Country:US
Mailing Address - Phone:303-534-0321
Mailing Address - Fax:
Practice Address - Street 1:12500 W 58TH AVE
Practice Address - Street 2:UNIT 103
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1103
Practice Address - Country:US
Practice Address - Phone:303-534-0321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QA0600X
261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO56323077Medicaid
COB9888OtherPUC
CO57450889Medicaid