Healthcare Provider Details

I. General information

NPI: 1093573123
Provider Name (Legal Business Name): HOMECARE HUB OF COLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 E PRENTICE AVE SUITE 1500
GREENWOOD VILLAGE CO
80111
US

IV. Provider business mailing address

8400 E PRENTICE AVE SUITE 1500
GREENWOOD VILLAGE CO
80111
US

V. Phone/Fax

Practice location:
  • Phone: 303-414-2770
  • Fax:
Mailing address:
  • Phone: 303-414-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DANIEL DEAK
Title or Position: PRESIDENT
Credential:
Phone: 303-414-2770