Healthcare Provider Details

I. General information

NPI: 1124562525
Provider Name (Legal Business Name): LIFE CHOICE HOSPICE OF COLORADO , LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 W 26TH AVE STE 200D
DENVER CO
80211-5303
US

IV. Provider business mailing address

10 CADILLAC DR STE 400
BRENTWOOD TN
37027-1001
US

V. Phone/Fax

Practice location:
  • Phone: 720-200-1036
  • Fax: 720-200-4514
Mailing address:
  • Phone: 615-377-7022
  • Fax: 615-373-4457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY JAMES
Title or Position: CFO/PRESIDENT
Credential:
Phone: 615-224-8028