Healthcare Provider Details

I. General information

NPI: 1558991380
Provider Name (Legal Business Name): 1PLUS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 01/21/2020
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 720-213-6318
  • Fax: 720-608-4131
Mailing address:
  • Phone: 720-213-6318
  • Fax: 720-608-4131

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: MIKHAIL SHELKOVICH
Title or Position: ADMINISTRATOR
Credential:
Phone: 720-499-8133