Healthcare Provider Details

I. General information

NPI: 1235336348
Provider Name (Legal Business Name): EBEN EZER IN-HOME SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 HOSPITAL RD
BRUSH CO
80723-1702
US

IV. Provider business mailing address

122 HOSPITAL RD
BRUSH CO
80723-1702
US

V. Phone/Fax

Practice location:
  • Phone: 970-842-6481
  • Fax: 970-842-3148
Mailing address:
  • Phone: 970-842-6481
  • Fax: 970-842-3148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number04138475
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number04138475
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number04138475
License Number StateCO

VIII. Authorized Official

Name: MS. RENEE LOWE
Title or Position: OFFICE MANAGER
Credential:
Phone: 970-842-6481