Healthcare Provider Details

I. General information

NPI: 1982053518
Provider Name (Legal Business Name): SCHAEFER ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2016
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 15TH STREET
GREELEY CO
80631
US

IV. Provider business mailing address

PO BOX 200009
EVANS CO
80620-0009
US

V. Phone/Fax

Practice location:
  • Phone: 970-353-0662
  • Fax: 970-353-2779
Mailing address:
  • Phone: 970-353-0662
  • Fax: 970-353-2779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number04L196
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number04L196
License Number StateCO

VIII. Authorized Official

Name: MRS. VALORIE ANNE RANDALL
Title or Position: EXECUTIVE DIRECTOR
Credential: MASTERS DEGREE
Phone: 970-353-0662