Healthcare Provider Details

I. General information

NPI: 1871151357
Provider Name (Legal Business Name): LUCKY YOU HOME CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 S PARKER RD STE 308
DENVER CO
80231-2922
US

IV. Provider business mailing address

17989 E DICKENSON PL
AURORA CO
80013-5909
US

V. Phone/Fax

Practice location:
  • Phone: 720-532-2920
  • Fax: 720-282-3337
Mailing address:
  • Phone: 720-532-2920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAYERA KAMILOVA
Title or Position: DIRECTOR/ADMINISTRATOR
Credential:
Phone: 720-532-2920