MEDICARE: COLORADO HOME HEALTH, 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

General Provider Information

NPI Number	:	1437648060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLORADO HOME HEALTH, LLC

Provider Business Mailing Address
First Line	:	1031 TITANITE PL
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80108-3076
Country	:	US
Telephone Number	:	303-856-6066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1031 TITANITE PL
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80108-3076
Country	:	US
Telephone Number	:	303-856-6606
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	LECIA WALKER
Credential	:
Telephone Number	:	720-618-2720

Provider Enumeration Date	:	05/09/2018
Last Update Date	:	11/20/2020

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