Healthcare Provider Details

I. General information

NPI: 1538981881
Provider Name (Legal Business Name): MOM'S HANDS HOMECARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20986 E 61ST AVE
AURORA CO
80019-2264
US

IV. Provider business mailing address

20986 E 61ST AVE
AURORA CO
80019-2264
US

V. Phone/Fax

Practice location:
  • Phone: 720-757-4293
  • Fax:
Mailing address:
  • Phone: 720-757-4293
  • 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: SEIFU TULU
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 720-757-4293