Provider Demographics
NPI:1437232360
Name:VOLUNTEERS OF AMERICA HOMESTEAD 2000, INC.
Entity Type:Organization
Organization Name:VOLUNTEERS OF AMERICA HOMESTEAD 2000, INC.
Other - Org Name:VOLUNTEERS OF AMERICA HOME HEALTH OF WESTERN COLORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST. SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-941-0305
Mailing Address - Street 1:7485 OFFICE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3690
Mailing Address - Country:US
Mailing Address - Phone:952-941-0305
Mailing Address - Fax:952-941-0428
Practice Address - Street 1:300 N CASCADE AVE STE T9
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-3576
Practice Address - Country:US
Practice Address - Phone:970-240-0139
Practice Address - Fax:970-240-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
66290OtherBLUE CROSS BLUE SHIELD
CO88582728Medicaid
067421Medicare ID - Type UnspecifiedMEDICARE