Healthcare Provider Details

I. General information

NPI: 1306352919
Provider Name (Legal Business Name): DEDICATED HOME SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 06/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6990 W 38TH AVE STE 100
WHEAT RIDGE CO
80033-4980
US

IV. Provider business mailing address

6990 W 38TH AVE STE 100
WHEAT RIDGE CO
80033-4980
US

V. Phone/Fax

Practice location:
  • Phone: 720-591-0000
  • Fax:
Mailing address:
  • Phone: 720-591-0000
  • 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: MR. LOUIS ADAM COLAIANNIA III
Title or Position: PRESIDENT
Credential:
Phone: 720-591-0000