Healthcare Provider Details

I. General information

NPI: 1922933357
Provider Name (Legal Business Name): ELDERBLOOM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 WINDING HILLS RD
MONUMENT CO
80132-9439
US

IV. Provider business mailing address

830 WINDING HILLS RD
MONUMENT CO
80132-9439
US

V. Phone/Fax

Practice location:
  • Phone: 719-201-5442
  • Fax: 719-201-5442
Mailing address:
  • Phone: 719-201-5442
  • Fax: 719-201-5442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LANA NICOLE SARGENT
Title or Position: OWNER
Credential:
Phone: 719-201-5442