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NPI Code Detail

MEDICARE: VINTAGE CARE LLC

MEDICARE: VINTAGE CARE 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1417526278
Entity Type Code : Organization
Provider Name (Legal Business Name) : VINTAGE CARE LLC
Provider Business Mailing Address
First Line : 151 SPRING ST
Second Line : 1138
City : MORRISON
State : CO
Zip : 80465
Country : US
Telephone Number : 720-577-5788
Fax Number :
Provider Business Practice Location Address
First Line : 151 SPRING ST
Second Line : 1138
City : MORRISON
State : CO
Zip : 80465
Country : US
Telephone Number : 720-577-5788
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. MELODY WEAVER
Credential : LPN
Telephone Number : 720-577-5788
Provider Enumeration Date : 06/24/2021
Last Update Date : 06/24/2021

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Directions to “VINTAGE CARE LLC ” Practice Location

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