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General NPI Number Information
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NPI Number | 1689524076
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Entity Type | Organization
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Legal Business Name | 2ND HOME COMMUNITY LIVING, LLC
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 7415 E 41ST AVE
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City | DENVER
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State | CO
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Zip | 80216-4707
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Country | US
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Telephone | 303-999-7763
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Fax |
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Provider Business Mailing Address
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Address Line | 3131 S VAUGHN WAY STE 600
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City | DENVER
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State | CO
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Zip | 80014-3508
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Country | US
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Telephone | 303-999-7763
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HANEEN OMAR
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Credential |
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Telephone | 303-999-7763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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