Healthcare Provider Details

I. General information

NPI: 1134872450
Provider Name (Legal Business Name): 3AHC21 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 W DRY CREEK CIR STE 820
LITTLETON CO
80120-8038
US

IV. Provider business mailing address

26 W DRY CREEK CIR STE 820
LITTLETON CO
80120-8038
US

V. Phone/Fax

Practice location:
  • Phone: 720-981-0804
  • Fax: 720-981-8443
Mailing address:
  • Phone: 720-981-0804
  • Fax: 720-981-8443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PETER GUERRERO
Title or Position: PRESIDENT
Credential:
Phone: 720-981-0804