Provider Demographics
NPI:1831284553
Name:ATLANTIC HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:ATLANTIC HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FATEMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:PANAHI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:303-377-8833
Mailing Address - Street 1:6667 E DORADO AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1706
Mailing Address - Country:US
Mailing Address - Phone:303-377-8833
Mailing Address - Fax:303-377-8877
Practice Address - Street 1:8810 E HAMPDEN AVE STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4926
Practice Address - Country:US
Practice Address - Phone:303-377-8833
Practice Address - Fax:303-377-8877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20021180265251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO46971831Medicaid
CO46971831Medicaid