Healthcare Provider Details

I. General information

NPI: 1750955092
Provider Name (Legal Business Name): TEAM SELECT HOME CARE OF COLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 S PARKER RD STE 930
AURORA CO
80014-2948
US

IV. Provider business mailing address

2999 N 44TH ST STE 100
PHOENIX AZ
85018-7247
US

V. Phone/Fax

Practice location:
  • Phone: 720-222-1388
  • Fax: 303-648-4191
Mailing address:
  • Phone: 480-618-5760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MIKE LOVELL
Title or Position: PRESIDENT
Credential:
Phone: 602-382-8500