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General NPI Number Information
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NPI Number | 1114288636
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Entity Type | Organization
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Legal Business Name | SENIOR HUB
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Dates
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Enumeration Date | 05/31/2012
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 9025 GRANT ST STE 150
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City | THORNTON
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State | CO
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Zip | 80229
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Country | US
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Telephone | 303-426-4408
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Fax | 303-426-0014
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Provider Business Mailing Address
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Address Line | 9025 GRANT ST STE 150
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City | THORNTON
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State | CO
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Zip | 80229-4346
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Country | US
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Telephone | 303-426-4408
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Fax | 303-426-0014
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | CALINA CHATELAIN BOWMAN
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Credential | DO
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Telephone | 303-426-4408
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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 | 04N287
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 04N287
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 04N287
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License Number State | CO
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