Healthcare Provider Details

I. General information

NPI: 1659674406
Provider Name (Legal Business Name): WILLIAM DAHLQUIST ENTERPRISES, INC., DBA HOME INSTEAD SENIOR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2010
Last Update Date: 12/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 S PONTIAC WAY
DENVER CO
80224-2411
US

IV. Provider business mailing address

2095 S PONTIAC WAY
DENVER CO
80224-2411
US

V. Phone/Fax

Practice location:
  • Phone: 303-389-5700
  • Fax: 303-389-5708
Mailing address:
  • Phone: 303-389-5700
  • Fax: 303-389-5708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number04B370
License Number StateCO

VIII. Authorized Official

Name: MR. WILLIAM P. DAHLQUIST
Title or Position: OWNER
Credential:
Phone: 303-389-5700