Healthcare Provider Details

I. General information

NPI: 1407750532
Provider Name (Legal Business Name): EXQUISITE CLEANERS COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 ALTA VISTA DR
CRAIG CO
81625-3225
US

IV. Provider business mailing address

PO BOX 217
CRAIG CO
81626-0217
US

V. Phone/Fax

Practice location:
  • Phone: 970-291-6296
  • Fax:
Mailing address:
  • Phone: 970-819-7179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAMONE EBANKS
Title or Position: PRESIDENT
Credential:
Phone: 970-819-7179