Healthcare Provider Details

I. General information

NPI: 1083345912
Provider Name (Legal Business Name): EOL HOME QUALITY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2022
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3128 EAGLE BLVD APT A302
BRIGHTON CO
80601-3725
US

IV. Provider business mailing address

3128 EAGLE BLVD APT A302
BRIGHTON CO
80601-3725
US

V. Phone/Fax

Practice location:
  • Phone: 720-651-3016
  • Fax:
Mailing address:
  • Phone: 720-651-3016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARTA GARCIA
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 720-651-3016