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NPI Code Detail

MEDICARE: EXTENDED CARE LLC

MEDICARE: EXTENDED 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
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2343900000XNon-emergency Medical Transport (VAN)
3347E00000XTransportation Broker
4385H00000XRespite Care
5320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility
6251E00000XHome Health Agency
7253Z00000XIn Home Supportive Care Agency
8251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1710542899
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXTENDED CARE LLC
Provider Business Mailing Address
First Line : 9725 E HAMPDEN AVE STE 101
Second Line :
City : DENVER
State : CO
Zip : 80231-4916
Country : US
Telephone Number : 720-532-0907
Fax Number : 720-282-4732
Provider Business Practice Location Address
First Line : 9725 E HAMPDEN AVE STE 101
Second Line :
City : DENVER
State : CO
Zip : 80231-4916
Country : US
Telephone Number : 720-532-0907
Fax Number : 720-282-4732
Authorized Official
Title or Position : OWNER/ EXECUTIVE DIRECTOR
Name : MRS. LATASHA STEPHENSON
Credential : BS
Telephone Number : 720-767-6054
Provider Enumeration Date : 05/05/2019
Last Update Date : 03/06/2025

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Directions to “EXTENDED CARE LLC ” Practice Location

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