Healthcare Provider Details

I. General information

NPI: 1225762495
Provider Name (Legal Business Name): FRIENDSHIP CARE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17940 E 95TH PL
COMMERCE CITY CO
80022-9664
US

IV. Provider business mailing address

17940 E 95TH PL
COMMERCE CITY CO
80022-9664
US

V. Phone/Fax

Practice location:
  • Phone: 720-473-9692
  • Fax:
Mailing address:
  • Phone: 720-473-9692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: ESKINDIR WORKU
Title or Position: DIRECTOR
Credential:
Phone: 720-473-9692