Healthcare Provider Details

I. General information

NPI: 1952923179
Provider Name (Legal Business Name): COLORADO FAMILY CAREGIVERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 07/15/2020
Certification Date: 07/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10475 ELIZABETH WAY
COLORADO SPRINGS CO
80908-1579
US

IV. Provider business mailing address

10475 ELIZABETH WAY
COLORADO SPRINGS CO
80908-1579
US

V. Phone/Fax

Practice location:
  • Phone: 303-898-9724
  • 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 Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DARRYL T PERKINS
Title or Position: VP OPERATIONS
Credential:
Phone: 303-898-9724