Healthcare Provider Details

I. General information

NPI: 1467875096
Provider Name (Legal Business Name): ALMA HISSONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2014
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 S PARKER RD STE 177
AURORA CO
80014-2748
US

IV. Provider business mailing address

2821 S PARKER RD STE 177
AURORA CO
80014-2748
US

V. Phone/Fax

Practice location:
  • Phone: 720-480-5086
  • Fax:
Mailing address:
  • Phone: 720-480-5086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: