MEDICARE: INNOVIVE 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

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

General Provider Information

NPI Number	:	1639886120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVIVE HEALTH OF COLORADO LLC

Provider Business Mailing Address
First Line	:	10 CABOT RD STE 201
Second Line	:
City	:	MEDFORD
State	:	MA
Zip	:	02155-5173
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1125 KELLY JOHNSON BLVD STE 300
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3930
Country	:	US
Telephone Number	:	800-915-3211
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	ANTHONY LOUMIDIS
Credential	:
Telephone Number	:	800-915-3211

Provider Enumeration Date	:	11/03/2022
Last Update Date	:	07/09/2025

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