Healthcare Provider Details

I. General information

NPI: 1427667948
Provider Name (Legal Business Name): CS HOME CARE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 S CIRCLE DR STE 350R
COLORADO SPRINGS CO
80906-4113
US

IV. Provider business mailing address

2860 S CIRCLE DR STE 350R
COLORADO SPRINGS CO
80906-4113
US

V. Phone/Fax

Practice location:
  • Phone: 719-419-7839
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: TAN TRUONG
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 719-460-3359