Healthcare Provider Details

I. General information

NPI: 1659282143
Provider Name (Legal Business Name): FAMOUS SALADS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 JASPER ST UNIT H
AURORA CO
80011-4662
US

IV. Provider business mailing address

2577 S TRUCKEE WAY
AURORA CO
80013-5925
US

V. Phone/Fax

Practice location:
  • Phone: 303-905-5184
  • Fax:
Mailing address:
  • Phone: 303-725-1399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: JEANNINE DICKENS
Title or Position: CEO/OWNER
Credential:
Phone: 303-725-1399