Provider Demographics
NPI:1831906775
Name:EVEREST ADULT DAY CARE LLC
Entity type:Organization
Organization Name:EVEREST ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SOM
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAL
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:720-612-7854
Mailing Address - Street 1:12201 E MISSISSIPPI AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3468
Mailing Address - Country:US
Mailing Address - Phone:720-612-7854
Mailing Address - Fax:
Practice Address - Street 1:2393 W 27TH ST STE 526
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-8046
Practice Address - Country:US
Practice Address - Phone:720-612-7854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVEREST ADULT DAY CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care