Provider Demographics
NPI:1831604016
Name:LIFE ADULT DAY CARE LLC
Entity type:Organization
Organization Name:LIFE ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DURGA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-989-0651
Mailing Address - Street 1:1390 S POTOMAC ST STE 116
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4529
Mailing Address - Country:US
Mailing Address - Phone:720-989-0651
Mailing Address - Fax:
Practice Address - Street 1:390 S POTOMAC WAY STE 116
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-1375
Practice Address - Country:US
Practice Address - Phone:720-989-0651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-09
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care