Healthcare Provider Details

I. General information

NPI: 1457225021
Provider Name (Legal Business Name): OVIC SKILLED HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21449 E UNION DR
AURORA CO
80015-4914
US

IV. Provider business mailing address

21449 E UNION DR
AURORA CO
80015-4914
US

V. Phone/Fax

Practice location:
  • Phone: 720-965-8318
  • Fax:
Mailing address:
  • Phone: 720-965-8318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: BETHLEHEM YENENEH
Title or Position: DIRECTOR OF NURSING
Credential: BSN, RN
Phone: 720-965-8318