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General NPI Number Information
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NPI Number | 1043618416
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Entity Type | Organization
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Legal Business Name | COLORADO FAMILY QUALITY HOME CARE
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 1450 S HAVANA ST SUITE410
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City | AURORA
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State | CO
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Zip | 80012-4018
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Country | US
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Telephone | 720-296-4293
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Fax | 303-632-7225
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Provider Business Mailing Address
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Address Line | 1450 S HAVANA ST STE 410
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City | AURORA
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State | CO
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Zip | 80012-4025
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Country | US
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Telephone | 720-296-4293
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Fax | 303-632-7225
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AMA KOOMSON
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Credential | REGISTERED NURSE
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Telephone | 303-632-7225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 04J169
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License Number State | CO
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