Provider Demographics
NPI:1326601402
Name:EMERALD BERYL HOMECARE LLC
Entity Type:Organization
Organization Name:EMERALD BERYL HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:KWAKYEWAA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:720-495-8485
Mailing Address - Street 1:3000 S JAMAICA CT STE 355
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2699
Mailing Address - Country:US
Mailing Address - Phone:720-495-8485
Mailing Address - Fax:
Practice Address - Street 1:3000 S JAMAICA CT STE 355
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2699
Practice Address - Country:US
Practice Address - Phone:720-495-8485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health