Organization
JNB HEADWATERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A OWSIANY (DIRECTOR)
(720) 202-1268
Entity
Organization
Contact information
Practice address
16791 S BRYNMAWR RD, PINE, CO 80470-8855
(303) 838-9784
(303) 838-9784
Mailing address
16791 S BRYNMAWR RD, PINE, CO 80470-8855
(303) 838-9784
(303) 838-9784
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
10/07/2016
Last updated
02/20/2017
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