Healthcare Provider Details

I. General information

NPI: 1720483282
Provider Name (Legal Business Name): R&R ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 RUTHERFORD AVE
JOHNSTOWN CO
80534-9998
US

IV. Provider business mailing address

21 RUTHERFORD AVE
JOHNSTOWN CO
80534-9998
US

V. Phone/Fax

Practice location:
  • Phone: 970-667-1067
  • Fax: 970-613-4311
Mailing address:
  • Phone: 970-667-1067
  • Fax: 970-613-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number04M458
License Number StateCO

VIII. Authorized Official

Name: DEEANNA E POWERS
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 970-619-0847