Provider Demographics
NPI:1053546960
Name:PRK WILLIAMS INC.
Entity type:Organization
Organization Name:PRK WILLIAMS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-851-2100
Mailing Address - Street 1:17011 LINCOLN AVE
Mailing Address - Street 2:#562
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3144
Mailing Address - Country:US
Mailing Address - Phone:720-851-2100
Mailing Address - Fax:303-248-9406
Practice Address - Street 1:10355 S PROGRESS WAY
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9672
Practice Address - Country:US
Practice Address - Phone:720-851-2100
Practice Address - Fax:303-248-9406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care