Provider Demographics
NPI:1346661667
Name:KOCH, LLC
Entity Type:Organization
Organization Name:KOCH, LLC
Other - Org Name:FIRSTLIGHT HOME CARE DENVER WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-953-9575
Mailing Address - Street 1:3000 YOUNGFIELD ST
Mailing Address - Street 2:SUITE 163
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80215-6545
Mailing Address - Country:US
Mailing Address - Phone:303-953-9575
Mailing Address - Fax:303-955-2791
Practice Address - Street 1:3000 YOUNGFIELD ST
Practice Address - Street 2:SUITE 163
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80215-6545
Practice Address - Country:US
Practice Address - Phone:303-953-9575
Practice Address - Fax:303-955-2791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-05
Last Update Date:2014-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04S218253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care