Healthcare Provider Details

I. General information

NPI: 1215928726
Provider Name (Legal Business Name): COMPASSIONATE HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11940 QUAY ST
BROOMFIELD CO
80020-2817
US

IV. Provider business mailing address

11940 QUAY ST
BROOMFIELD CO
80020-2817
US

V. Phone/Fax

Practice location:
  • Phone: 303-465-3700
  • Fax: 303-465-2516
Mailing address:
  • Phone: 303-465-3700
  • Fax: 303-465-2516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. VICKI KIESAU
Title or Position: PRESIDENT
Credential:
Phone: 303-465-3700