Provider Demographics
NPI:1821157934
Name:SENIORS INC
Entity Type:Organization
Organization Name:SENIORS INC
Other - Org Name:INNOVAGE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DESPOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-912-1402
Mailing Address - Street 1:445 E 124TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2402
Mailing Address - Country:US
Mailing Address - Phone:303-214-4194
Mailing Address - Fax:
Practice Address - Street 1:445 E 124TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2402
Practice Address - Country:US
Practice Address - Phone:303-214-4194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Not Answered347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04143731Medicaid
CO04142667Medicaid
CO07509375Medicaid