Healthcare Provider Details

I. General information

NPI: 1891311726
Provider Name (Legal Business Name): CAREGIVERS VILLAGE COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 09/26/2020
Certification Date: 09/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6252 POWELL RD
PARKER CO
80134-5619
US

IV. Provider business mailing address

6252 POWELL RD
PARKER CO
80134-5619
US

V. Phone/Fax

Practice location:
  • Phone: 303-717-2593
  • Fax:
Mailing address:
  • Phone: 303-717-2593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DENISE BUNCH
Title or Position: MEMBER
Credential:
Phone: 303-717-2593