=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508753245
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME TOWN HOME CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2025
-----------------------------------------------------
Last Update Date | 06/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60 HICKORY AVE STE 1
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80720-1804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-360-9669
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 441 HALE ST
-----------------------------------------------------
City | WRAY
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80758-1412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-630-9896
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | SANDRA GLASER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 970-360-9669
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------