Provider Demographics
NPI:1255694337
Name:AT YOUR SERVICE HOME CARE
Entity Type:Organization
Organization Name:AT YOUR SERVICE HOME CARE
Other - Org Name:ALL VALLEY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-221-1841
Mailing Address - Street 1:7600 E ARAPAHOE RD
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1260
Mailing Address - Country:US
Mailing Address - Phone:303-221-1841
Mailing Address - Fax:
Practice Address - Street 1:7600 E ARAPAHOE RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1260
Practice Address - Country:US
Practice Address - Phone:303-221-1841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04Z786253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO15027279Medicaid