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General NPI Number Information
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NPI Number | 1174343453
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Entity Type | Organization
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Legal Business Name | NISSI HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 15290 E 6TH AVE UNIT 210D
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City | AURORA
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State | CO
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Zip | 80011-3449
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Country | US
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Telephone | 720-594-0593
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Fax |
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Provider Business Mailing Address
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Address Line | 15290 E 6TH AVE UNIT 210D
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City | AURORA
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State | CO
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Zip | 80011-3449
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Country | US
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Telephone | 720-594-0593
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MR. VICTOR OLUTOSIN AJAYI
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Credential |
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Telephone | 720-594-0593
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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