Provider Demographics
NPI:1164281341
Name:CHERRY HILL HOME HEALTH LLC
Entity Type:Organization
Organization Name:CHERRY HILL HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SISAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-779-6142
Mailing Address - Street 1:24067 E 3RD PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80018-1571
Mailing Address - Country:US
Mailing Address - Phone:720-779-6142
Mailing Address - Fax:
Practice Address - Street 1:24067 E 3RD PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80018-1571
Practice Address - Country:US
Practice Address - Phone:720-779-6142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health