Healthcare Provider Details

I. General information

NPI: 1518544592
Provider Name (Legal Business Name): CENTREPOINT SUPPORT LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6892 S YOSEMITE CT # 1-101A
CENTENNIAL CO
80112-1464
US

IV. Provider business mailing address

6892 S YOSEMITE CT # 1-101A
CENTENNIAL CO
80112-1464
US

V. Phone/Fax

Practice location:
  • Phone: 303-591-2185
  • Fax:
Mailing address:
  • Phone: 303-591-2185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. TERRY R. WILLIAMS
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 303-591-2185