Provider Demographics
NPI:1528576816
Name:ELEMENT HOME CARE LLC
Entity Type:Organization
Organization Name:ELEMENT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROEPKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-900-8820
Mailing Address - Street 1:8145 CANDLEFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-5753
Mailing Address - Country:US
Mailing Address - Phone:719-900-8820
Mailing Address - Fax:
Practice Address - Street 1:8145 CANDLEFLOWER CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-5753
Practice Address - Country:US
Practice Address - Phone:719-900-8820
Practice Address - Fax:855-275-5715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-20
Last Update Date:2018-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04X825253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care