Provider Demographics
NPI:1609610039
Name:GRAY, DALANIA
Entity type:Individual
Prefix:
First Name:DALANIA
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DALANIA
Other - Middle Name:DIANE
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANNIE AND CARES LLC
Mailing Address - Street 1:8767 S JAMAICA ST UNIT 4208
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-7644
Mailing Address - Country:US
Mailing Address - Phone:303-328-1444
Mailing Address - Fax:
Practice Address - Street 1:8767 S JAMAICA ST UNIT 4208
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-7644
Practice Address - Country:US
Practice Address - Phone:303-328-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00407270374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty