Provider Demographics
NPI:1578381760
Name:ABBEY ROAD AND PENNY LANE LLC
Entity type:Organization
Organization Name:ABBEY ROAD AND PENNY LANE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOS
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WATWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-990-8347
Mailing Address - Street 1:5897 S WALDEN ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5912
Mailing Address - Country:US
Mailing Address - Phone:720-990-8347
Mailing Address - Fax:
Practice Address - Street 1:8250 E BRIARWOOD AVE
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1307
Practice Address - Country:US
Practice Address - Phone:720-990-8347
Practice Address - Fax:720-808-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care