Healthcare Provider Details

I. General information

NPI: 1437889748
Provider Name (Legal Business Name): ATLAS NURSING CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 06/10/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4195 NEVIS ST
BOULDER CO
80301-6818
US

IV. Provider business mailing address

PO BOX 18891
BOULDER CO
80308-1891
US

V. Phone/Fax

Practice location:
  • Phone: 720-887-5786
  • Fax:
Mailing address:
  • Phone: 720-887-5786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SANJAY K GAGAD
Title or Position: OWNER
Credential: RN
Phone: 720-887-5786