=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780558247
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHI NATIONAL HOME CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2025
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9100 E MINERAL CIR
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80112-3401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-561-5193
-----------------------------------------------------
Fax | 720-455-9546
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6281 TRI RIDGE BLVD STE 300
-----------------------------------------------------
City | LOVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45140-8345
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-576-0262
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP FINANCE CFO
-----------------------------------------------------
Name | JACK DANIEL HAWKINS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 513-477-6305
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------