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General NPI Number Information
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NPI Number | 1669962395
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Entity Type | Organization
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Legal Business Name | HOME HEALTH CARE COLORADO LLC
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Dates
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Enumeration Date | 05/17/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 16429 HOMESTEAD CT
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City | PARKER
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State | CO
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Zip | 80134-9344
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Country | US
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Telephone | 720-515-1070
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Fax |
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Provider Business Mailing Address
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Address Line | 16429 HOMESTEAD CT
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City | PARKER
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State | CO
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Zip | 80134-9344
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Country | US
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Telephone | 720-515-1070
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Fax |
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Authorized Official
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Title or Position | ALTERNATE ADMINISTRATOR
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Name | MR. SHANE BRANDT
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Credential |
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Telephone | 720-515-1070
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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 | 04X115
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License Number State | CO
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