Provider Demographics
NPI:1558315218
Name:HEART OF THE ROCKIES HOME HEALTH, LLC
Entity Type:Organization
Organization Name:HEART OF THE ROCKIES HOME HEALTH, LLC
Other - Org Name:ENHABIT HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:JOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-239-6500
Mailing Address - Street 1:6688 N CENTRAL EXPY STE 1300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-3950
Mailing Address - Country:US
Mailing Address - Phone:214-239-6500
Mailing Address - Fax:214-239-6581
Practice Address - Street 1:301 OAK ST
Practice Address - Street 2:UNIT E
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-3338
Practice Address - Country:US
Practice Address - Phone:719-539-2467
Practice Address - Fax:719-539-5056
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENHABIT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-19
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1169251G00000X
CO0563251G00000X
CO170636251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO92679269Medicaid
061525Medicare ID - Type UnspecifiedMEDICARE
CO061525Medicare Oscar/Certification