Provider Demographics
NPI:1518514876
Name:CHARITY CARES HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:CHARITY CARES HOME CARE AGENCY LLC
Other - Org Name:CHARITY CARES AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ DIRECTOR OF OPERARTIONS
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-238-7802
Mailing Address - Street 1:2850 W SERENDIPITY CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-3415
Mailing Address - Country:US
Mailing Address - Phone:719-257-2119
Mailing Address - Fax:719-465-3486
Practice Address - Street 1:2850 W SERENDIPITY CIR STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3415
Practice Address - Country:US
Practice Address - Phone:719-257-2119
Practice Address - Fax:719-465-8634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-21
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care