Healthcare Provider Details

I. General information

NPI: 1659734465
Provider Name (Legal Business Name): CAREPROX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 N BROADWAY SUITE 2-204
DENVER CO
80221-2914
US

IV. Provider business mailing address

7000 N BROADWAY SUITE 2-204
DENVER CO
80221-2914
US

V. Phone/Fax

Practice location:
  • Phone: 720-285-7033
  • Fax: 303-284-4390
Mailing address:
  • Phone: 720-285-7033
  • Fax: 303-284-4390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number85621552
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number88981061
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number65377869
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number85621552
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number85621552
License Number StateCO

VIII. Authorized Official

Name: VICTOR GABOJUKWU
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential: CAO
Phone: 720-285-7033