Healthcare Provider Details

I. General information

NPI: 1013379825
Provider Name (Legal Business Name): ROOTING FOR MOM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 E LINKS PKWY
CENTENNIAL CO
80122-3718
US

IV. Provider business mailing address

4333 E LINKS PKWY
CENTENNIAL CO
80122-3718
US

V. Phone/Fax

Practice location:
  • Phone: 978-494-3578
  • Fax:
Mailing address:
  • Phone: 978-494-3578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number20166000281
License Number StateCO

VIII. Authorized Official

Name: MR. CHRISTOPHER MAHONEY
Title or Position: CEO
Credential:
Phone: 978-494-3578