Provider Demographics
NPI:1437609252
Name:COACH HOME HEALTH AGENCY, LLC
Entity Type:Organization
Organization Name:COACH HOME HEALTH AGENCY, LLC
Other - Org Name:CENTERCARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-391-4444
Mailing Address - Street 1:6760 CORPORATE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1986
Mailing Address - Country:US
Mailing Address - Phone:719-600-3040
Mailing Address - Fax:719-260-2644
Practice Address - Street 1:6760 CORPORATE DR STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-1986
Practice Address - Country:US
Practice Address - Phone:719-600-3040
Practice Address - Fax:719-896-5384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health