Provider Demographics
NPI:1598764656
Name:PROSPECT HOME CARE-HOSPICE, INC.
Entity Type:Organization
Organization Name:PROSPECT HOME CARE-HOSPICE, INC.
Other - Org Name:PROSPECT HOME CARE & HOSPICE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARROWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-687-0549
Mailing Address - Street 1:16222 HIGHWAY 24
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863
Mailing Address - Country:US
Mailing Address - Phone:719-687-0549
Mailing Address - Fax:719-687-8558
Practice Address - Street 1:16222 HIGHWAY 24
Practice Address - Street 2:SUITE 120
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863
Practice Address - Country:US
Practice Address - Phone:719-687-0549
Practice Address - Fax:719-687-8558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0396251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05800040Medicaid
CO06-1507Medicare ID - Type UnspecifiedHOME HOSPICE