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General NPI Number Information
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NPI Number | 1881984797
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Entity Type | Organization
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Legal Business Name | FRONT RANGE COMFORCARE
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 3333 S WADSWORTH BLVD SUITE D-312
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City | LAKEWOOD
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State | CO
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Zip | 80227
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Country | US
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Telephone | 303-232-4473
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Fax | 720-294-9740
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Provider Business Mailing Address
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Address Line | 3333 S WADSWORTH BLVD SUITE D-312
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City | LAKEWOOD
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State | CO
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Zip | 80227
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Country | US
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Telephone | 303-232-4473
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Fax | 720-294-9740
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ERIC EDWARDS
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Credential |
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Telephone | 303-232-4473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 04S932
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License Number State | CO
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