=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376459933
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EDENBROOKE HEALTH CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/21/2026
-----------------------------------------------------
Last Update Date | 08/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15200 E GIRARD AVE STE 4800
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80014-5054
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-953-9581
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2325 S GENOA ST
-----------------------------------------------------
City | AURORA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80013-6267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-953-9581
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR/PRESIDENT
-----------------------------------------------------
Name | CECILIA YEBOAH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 720-953-9581
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311Z00000X
-----------------------------------------------------
Taxonomy Name | Custodial Care Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------