Provider Demographics
NPI:1487017455
Name:PERSONAL HOME CARE PLUS LLC
Entity Type:Organization
Organization Name:PERSONAL HOME CARE PLUS LLC
Other - Org Name:PERSONAL CARE PROVIDERS HOME CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ROCKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-807-4044
Mailing Address - Street 1:8061 SHAFFER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3762
Mailing Address - Country:US
Mailing Address - Phone:303-807-4044
Mailing Address - Fax:720-749-1766
Practice Address - Street 1:8061 SHAFFER PARKWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3762
Practice Address - Country:US
Practice Address - Phone:844-466-4889
Practice Address - Fax:720-749-1766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO30230055Medicaid