Provider Demographics
NPI:1659734465
Name:CAREPROX LLC
Entity Type:Organization
Organization Name:CAREPROX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GABOJUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:CAO
Authorized Official - Phone:720-285-7033
Mailing Address - Street 1:7000 N BROADWAY
Mailing Address - Street 2:SUITE 2-204
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-2914
Mailing Address - Country:US
Mailing Address - Phone:720-285-7033
Mailing Address - Fax:303-284-4390
Practice Address - Street 1:7000 N BROADWAY
Practice Address - Street 2:SUITE 2-204
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-2914
Practice Address - Country:US
Practice Address - Phone:720-285-7033
Practice Address - Fax:303-284-4390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO85621552251C00000X, 253Z00000X, 385HR2065X
CO88981061261QA0600X
CO65377869343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO65377869Medicaid
CO88981061Medicaid
CO85621552Medicaid