Provider Demographics
NPI:1033676192
Name:AGE IN PLACE HOME HEALTH
Entity Type:Organization
Organization Name:AGE IN PLACE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-548-4310
Mailing Address - Street 1:11375 E VASSAR DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1836
Mailing Address - Country:US
Mailing Address - Phone:303-548-4310
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:11375 E VASSAR DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1836
Practice Address - Country:US
Practice Address - Phone:303-548-4310
Practice Address - Fax:000-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
123456OtherINTERNAL USE