Healthcare Provider Details

I. General information

NPI: 1285909093
Provider Name (Legal Business Name): GIVEN' HOME HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3198 F RD STE 101
GRAND JUNCTION CO
81504-4039
US

IV. Provider business mailing address

3198 F RD STE 101
GRAND JUNCTION CO
81504-4039
US

V. Phone/Fax

Practice location:
  • Phone: 970-985-4483
  • Fax: 970-985-4067
Mailing address:
  • Phone: 970-985-4483
  • Fax: 970-985-4067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number04G928
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number04M216
License Number StateCO

VIII. Authorized Official

Name: MS. SANDRA J SHEPHERD
Title or Position: CEO, ADMINISTRATOR
Credential: RN
Phone: 970-985-4483