Healthcare Provider Details

I. General information

NPI: 1659946051
Provider Name (Legal Business Name): 5280 ELEVATED HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3108 W HAMPDEN AVE STE G
ENGLEWOOD CO
80110-3273
US

IV. Provider business mailing address

3108 W HAMPDEN AVE STE G
ENGLEWOOD CO
80110-3273
US

V. Phone/Fax

Practice location:
  • Phone: 303-717-8037
  • Fax:
Mailing address:
  • Phone: 303-717-8037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. BETH A CALIX
Title or Position: REGISTERED NURSE/OWNER
Credential: RN, BSN
Phone: 303-717-8037