Provider Demographics
NPI:1144792128
Name:CONSTANCE HOME CARE LLC, THERESA
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:CONSTANCE HOME CARE LLC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 S OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4233
Mailing Address - Country:US
Mailing Address - Phone:720-276-3604
Mailing Address - Fax:
Practice Address - Street 1:1336 S OAKLAND ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4233
Practice Address - Country:US
Practice Address - Phone:720-276-3604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-01
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service