MEDICARE: HOMECARE HUB, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1578071957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMECARE HUB, LLC

Provider Business Mailing Address
First Line	:	8400 E PRENTICE AVE PH 1500
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-2927
Country	:	US
Telephone Number	:	616-581-7878
Fax Number	:

Provider Business Practice Location Address
First Line	:	8400 E PRENTICE AVE PH 1500
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-2927
Country	:	US
Telephone Number	:	616-581-7878
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL DEAK
Credential	:
Telephone Number	:	616-581-7878

Provider Enumeration Date	:	01/18/2018
Last Update Date	:	09/19/2024

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