Provider Demographics
NPI:1558526426
Name:GENERATIONS AT HOME, LLC
Entity Type:Organization
Organization Name:GENERATIONS AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEKER
Authorized Official - Suffix:
Authorized Official - Credentials:NHA, MHS
Authorized Official - Phone:720-858-6610
Mailing Address - Street 1:8505 E LOWRY BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7030
Mailing Address - Country:US
Mailing Address - Phone:720-317-2800
Mailing Address - Fax:720-974-9025
Practice Address - Street 1:8505 E LOWRY BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7030
Practice Address - Country:US
Practice Address - Phone:720-317-2800
Practice Address - Fax:720-974-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85673731Medicaid