Provider Demographics
NPI:1811231467
Name:MONUMENT SENIOR CARE LLC
Entity Type:Organization
Organization Name:MONUMENT SENIOR CARE LLC
Other - Org Name:MONUMENT HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:BEAIRD
Authorized Official - Last Name:KEMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-858-2433
Mailing Address - Street 1:2829 NORTH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-5368
Mailing Address - Country:US
Mailing Address - Phone:970-985-4924
Mailing Address - Fax:970-985-4925
Practice Address - Street 1:2829 NORTH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-5368
Practice Address - Country:US
Practice Address - Phone:970-985-4924
Practice Address - Fax:970-985-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04V724253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care