Provider Demographics
NPI:1326580119
Name:CENTER HOME CARE INC. OF THE ROCKIES
Entity Type:Organization
Organization Name:CENTER HOME CARE INC. OF THE ROCKIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-358-2933
Mailing Address - Street 1:721 4TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:FORT LUPTON
Mailing Address - State:CO
Mailing Address - Zip Code:80621-1846
Mailing Address - Country:US
Mailing Address - Phone:720-358-2933
Mailing Address - Fax:
Practice Address - Street 1:721 4TH ST STE A
Practice Address - Street 2:
Practice Address - City:FORT LUPTON
Practice Address - State:CO
Practice Address - Zip Code:80621-1846
Practice Address - Country:US
Practice Address - Phone:720-358-2933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04E906253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care