Provider Demographics
NPI:1639959471
Name:NORTHGATE HOME CARE LLC
Entity Type:Organization
Organization Name:NORTHGATE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:719-428-3455
Mailing Address - Street 1:7608 N UNION BLVD STE 145
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3867
Mailing Address - Country:US
Mailing Address - Phone:719-428-3455
Mailing Address - Fax:719-428-3552
Practice Address - Street 1:7608 N UNION BLVD STE 145
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3867
Practice Address - Country:US
Practice Address - Phone:719-428-3455
Practice Address - Fax:719-428-3552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care