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General NPI Number Information
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NPI Number | 1114386448
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Entity Type | Organization
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Legal Business Name | THE COACH HOME CARE AND CONSULTING AGENCY, LLC
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 1900 E PIKES PEAK AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5850
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Country | US
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Telephone | 719-391-4444
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Fax | 719-390-6895
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Provider Business Mailing Address
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Address Line | 1900 E PIKES PEAK AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5850
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Country | US
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Telephone | 719-391-4444
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Fax | 719-390-6895
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CHRISTEL AIME
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Credential | RN-BSN
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Telephone | 719-231-2152
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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 | 04M594
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License Number State | CO
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