Healthcare Provider Details

I. General information

NPI: 1265098065
Provider Name (Legal Business Name): JTM HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10128A AIRPORT CT UNIT 1
BROOMFIELD CO
80021-2548
US

IV. Provider business mailing address

10128A AIRPORT CT UNIT 1
BROOMFIELD CO
80021-2548
US

V. Phone/Fax

Practice location:
  • Phone: 303-848-8703
  • Fax: 303-997-1047
Mailing address:
  • Phone: 303-848-8703
  • Fax: 303-997-1047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: JAMES MIDDLETON
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 303-848-8703