Healthcare Provider Details

I. General information

NPI: 1417261520
Provider Name (Legal Business Name): QUEEN'S CARE IN HOME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5054 BILLINGS ST
DENVER CO
80239-4323
US

IV. Provider business mailing address

5054 BILLINGS ST
DENVER CO
80239-4323
US

V. Phone/Fax

Practice location:
  • Phone: 303-371-6588
  • Fax: 303-371-6637
Mailing address:
  • Phone: 303-371-6588
  • Fax: 303-371-6637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number04E902
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number04F397
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberB-10054
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. QUEEN MOSES
Title or Position: OWNER
Credential:
Phone: 303-371-6588