Healthcare Provider Details

I. General information

NPI: 1942048194
Provider Name (Legal Business Name): DJC HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 E FLORIDA AVE APT 1-202
DENVER CO
80247
US

IV. Provider business mailing address

9100 E FLORIDA AVE 1-202
DENVER CO
80247-2846
US

V. Phone/Fax

Practice location:
  • Phone: 602-315-8160
  • Fax:
Mailing address:
  • Phone: 602-315-8160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JUSTINE CHUKWUMA
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 602-315-8160