Provider Demographics
NPI:1700419488
Name:HANNA CARES, LLC
Entity Type:Organization
Organization Name:HANNA CARES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:GULTOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-579-6204
Mailing Address - Street 1:6550 S IDER ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1251
Mailing Address - Country:US
Mailing Address - Phone:720-579-6204
Mailing Address - Fax:
Practice Address - Street 1:6550 S IDER ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1251
Practice Address - Country:US
Practice Address - Phone:720-601-1645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care