MEDICARE: BE THE PART HOMECARE , 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	376J00000X	Homemaker
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1740091677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE THE PART HOMECARE , LLC

Provider Business Mailing Address
First Line	:	6746 EDMONDSTOWN DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-7704
Country	:	US
Telephone Number	:	719-678-1078
Fax Number	:

Provider Business Practice Location Address
First Line	:	6746 EDMONDSTOWN DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-7704
Country	:	US
Telephone Number	:	719-678-1078
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. KENNETH OBIERO
Credential	:	ADMINISTRATOR
Telephone Number	:	719-678-1078

Provider Enumeration Date	:	01/20/2025
Last Update Date	:	01/20/2025

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Directions to “BE THE PART HOMECARE , LLC ” Practice Location

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