Healthcare Provider Details

I. General information

NPI: 1306493960
Provider Name (Legal Business Name): PURDUE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20210 E PURDUE PL
AURORA CO
80013-6073
US

IV. Provider business mailing address

22093 E GRAND DR
CENTENNIAL CO
80015-4713
US

V. Phone/Fax

Practice location:
  • Phone: 720-299-0537
  • Fax:
Mailing address:
  • Phone: 720-299-0537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: EMNET MAMO
Title or Position: DIRECTOR
Credential:
Phone: 720-299-0537