Organization
DIVINE DEDICATION HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RAQUEL L MARTIN (ADMIN)
(303) 751-7077
Entity
Organization
Contact information
Practice address
2851 S PARKER RD, #428, AURORA, CO 80014-2736
(303) 751-7077
Mailing address
2851 S PARKER RD STE 428, AURORA, CO 80014-2802
(303) 751-7077
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
251E00000X
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70283231
—
CO
Enumeration date
06/06/2007
Last updated
05/12/2016
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