Healthcare Provider Details

I. General information

NPI: 1114422706
Provider Name (Legal Business Name): NOCO HEALING HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 GARDEN DRIVE UNIT O, SUITE 100
WINDSOR CO
80550
US

IV. Provider business mailing address

609 LOCUST ST
WINDSOR CO
80550-5265
US

V. Phone/Fax

Practice location:
  • Phone: 970-397-5409
  • Fax:
Mailing address:
  • Phone: 970-397-5409
  • Fax:

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. LAURA ANN WINING
Title or Position: MEMBER/DIRECTOR OF NURSING
Credential: RN
Phone: 970-397-5409