Healthcare Provider Details

I. General information

NPI: 1285372201
Provider Name (Legal Business Name): FAP TENDER CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12296 KALISPELL ST
COMMERCE CITY CO
80603-6961
US

IV. Provider business mailing address

12296 KALISPELL ST
COMMERCE CITY CO
80603-6961
US

V. Phone/Fax

Practice location:
  • Phone: 720-804-6111
  • Fax:
Mailing address:
  • Phone: 720-804-6111
  • Fax:

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 TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: OMON UANRERORO
Title or Position: DIRECTOR
Credential:
Phone: 720-804-6111