Healthcare Provider Details

I. General information

NPI: 1619189727
Provider Name (Legal Business Name): INDEPENDENT GROWTH HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14201 E. 4TH AVE. BLDG. 4, SUITE 130
AURORA CO
80011
US

IV. Provider business mailing address

14201 E. 4TH AVE. BLDG. 4, SUITE 130
AURORA CO
80011
US

V. Phone/Fax

Practice location:
  • Phone: 303-343-9800
  • Fax: 303-349-9800
Mailing address:
  • Phone: 303-343-9800
  • Fax: 303-343-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number16431022
License Number StateCO

VIII. Authorized Official

Name: MR. PAUL L JONES JR.
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 303-343-9800