Provider Demographics
NPI:1225135403
Name:BERKLEY HOME HEALTH CARE SYSTEMS, LLC
Entity Type:Organization
Organization Name:BERKLEY HOME HEALTH CARE SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DONNAY
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:303-758-2000
Mailing Address - Street 1:10697 E DARTMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2616
Mailing Address - Country:US
Mailing Address - Phone:303-758-2000
Mailing Address - Fax:303-758-2009
Practice Address - Street 1:10697 E DARTMOUTH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2616
Practice Address - Country:US
Practice Address - Phone:303-758-2000
Practice Address - Fax:303-758-2009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04049F251E00000X
CO67687326332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO40251276Medicaid
CO67687326Medicaid
CO067407Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CO5350000001Medicare NSC