Healthcare Provider Details
I. General information
NPI: 1336493063
Provider Name (Legal Business Name): LIFE CHOICE HOSPICE OF COLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2012
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4704 HARLAN ST STE 550
DENVER CO
80212-7464
US
IV. Provider business mailing address
10 CADILLAC DR SUITE 400
BRENTWOOD TN
37027-5078
US
V. Phone/Fax
- Phone: 720-200-1036
- Fax: 720-200-4514
- Phone: 615-377-7022
- Fax: 615-373-4457
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RUSSELL
ADKINS
Title or Position: SVP GENERAL COUNSEL
Credential:
Phone: 615-926-0340