MEDICARE: FAP TENDER CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	376J00000X	Homemaker
2	385H00000X	Respite Care
3	251C00000X	Developmentally Disabled Services Day Training Agency
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1285372201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAP TENDER CARE LLC

Provider Business Mailing Address
First Line	:	12296 KALISPELL ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80603-6961
Country	:	US
Telephone Number	:	720-804-6111
Fax Number	:

Provider Business Practice Location Address
First Line	:	12296 KALISPELL ST
Second Line	:
City	:	COMMERCE CITY
State	:	CO
Zip	:	80603-6961
Country	:	US
Telephone Number	:	720-804-6111
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	OMON UANRERORO
Credential	:
Telephone Number	:	720-804-6111

Provider Enumeration Date	:	05/20/2022
Last Update Date	:	04/16/2026

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