Provider Demographics
NPI:1194022343
Name:COMPLETE CARE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:COMPLETE CARE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-985-0646
Mailing Address - Street 1:3600 S WADSWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2103
Mailing Address - Country:US
Mailing Address - Phone:303-985-0646
Mailing Address - Fax:303-985-3834
Practice Address - Street 1:3600 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2103
Practice Address - Country:US
Practice Address - Phone:303-985-0646
Practice Address - Fax:303-985-3834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC26643Medicare UPIN