Provider Demographics
NPI:1346966199
Name:PIVOT HOME HEALTH, LLC
Entity Type:Organization
Organization Name:PIVOT HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:ROUDEBUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-231-7937
Mailing Address - Street 1:4251 KIPLING ST UNIT 500
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2899
Mailing Address - Country:US
Mailing Address - Phone:720-231-7937
Mailing Address - Fax:
Practice Address - Street 1:4251 KIPLING ST UNIT 500
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2899
Practice Address - Country:US
Practice Address - Phone:720-231-7937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health