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General NPI Number Information
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NPI Number | 1700472834
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Entity Type | Organization
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Legal Business Name | CAREGENIX HOME HEALTH CARE LLC.
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Dates
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Enumeration Date | 12/13/2020
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Last Update Date | 12/13/2020
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Provider Practice Location Address
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Address Line | 1821 S 11TH ST APT B
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City | LARAMIE
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State | WY
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Zip | 82070-5590
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Country | US
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Telephone | 307-263-1610
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Fax | 307-263-1610
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Provider Business Mailing Address
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Address Line | 1821 S 11TH ST APT B
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City | LARAMIE
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State | WY
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Zip | 82070-5590
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Country | US
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Telephone | 307-263-1610
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Fax | 307-263-1610
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROSEMARY VON BODEN
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Credential | RN
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Telephone | 307-263-1610
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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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