MEDICARE: EH HOME HEALTH OF COLORADO LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	04Q268	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	06D1037068	OTHER	CO	CLIA

General Provider Information

NPI Number	:	1346481710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EH HOME HEALTH OF COLORADO LLC

Provider Business Mailing Address
First Line	:	6688 N CENTRAL EXPY
Second Line	:	SUITE 1300
City	:	DALLAS
State	:	TX
Zip	:	75206-3950
Country	:	US
Telephone Number	:	214-239-6500
Fax Number	:	214-239-6581

Provider Business Practice Location Address
First Line	:	910 PINON RANCH VIEW
Second Line	:	SUITE 211, BLDG 4, UNIT A
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907
Country	:	US
Telephone Number	:	719-265-6931
Fax Number	:	719-265-6934

Authorized Official
Title or Position	:	EVP OF HOME HEALTH OPERATIONS
Name	:	JULIE DIANE JOLLEY
Credential	:
Telephone Number	:	214-239-6500

Provider Enumeration Date	:	03/16/2009
Last Update Date	:	12/23/2024

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