Healthcare Provider Details

I. General information

NPI: 1457459786
Provider Name (Legal Business Name): NURSECORE MANAGEMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/19/2022
Certification Date: 04/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5426 N ACADEMY BLVD STE 110
COLORADO SPRINGS CO
80918-3686
US

IV. Provider business mailing address

PO BOX 201925
ARLINGTON TX
76006-1925
US

V. Phone/Fax

Practice location:
  • Phone: 719-884-1388
  • Fax:
Mailing address:
  • Phone: 817-649-1166
  • Fax: 817-649-2638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH LOLLAR
Title or Position: PRESIDENT/CEO
Credential:
Phone: 817-649-1166