Provider Demographics
NPI:1477598357
Name:DYNAMIC SERVICES INC
Entity Type:Organization
Organization Name:DYNAMIC SERVICES INC
Other - Org Name:SELECT HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GARDINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-428-6200
Mailing Address - Street 1:7475 DAKIN ST
Mailing Address - Street 2:STE. 400
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-6926
Mailing Address - Country:US
Mailing Address - Phone:303-428-6200
Mailing Address - Fax:303-428-6221
Practice Address - Street 1:7475 DAKIN ST
Practice Address - Street 2:STE. 400
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-6926
Practice Address - Country:US
Practice Address - Phone:303-428-6200
Practice Address - Fax:303-428-6221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO067239251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO126424Medicaid
CO05701116Medicaid
CO067239Medicare Oscar/Certification