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General NPI Number Information
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NPI Number | 1770998544
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Entity Type | Organization
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Legal Business Name | DOMINICAN HOME HEALTH AGENCY, INC.
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 06/30/2014
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Provider Practice Location Address
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Address Line | 2501 GAYLORD ST
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City | DENVER
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State | CO
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Zip | 80205-5631
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Country | US
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Telephone | 303-322-1413
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Fax | 303-322-2702
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Provider Business Mailing Address
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Address Line | 2501 GAYLORD ST
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City | DENVER
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State | CO
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Zip | 80205-5631
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Country | US
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Telephone | 303-322-1413
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Fax | 303-322-2702
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KRISANDRA PANTING
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Credential | BSN,RN,MBA
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Telephone | 30303221413
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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 | 04F925
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License Number State | CO
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