Provider Demographics
NPI:1073145025
Name:HOME CARE COLORADO, LLC
Entity Type:Organization
Organization Name:HOME CARE COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-204-5788
Mailing Address - Street 1:2919 17TH AVE.
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503
Mailing Address - Country:US
Mailing Address - Phone:720-204-5788
Mailing Address - Fax:
Practice Address - Street 1:2919 17TH AVE.
Practice Address - Street 2:SUITE 215
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503
Practice Address - Country:US
Practice Address - Phone:720-204-5788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care