Provider Demographics
NPI:1851982672
Name:YOLO 5, LLC
Entity Type:Organization
Organization Name:YOLO 5, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGIL-NAMOCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-317-4448
Mailing Address - Street 1:2260 S XANADU WAY STE 210
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-6557
Mailing Address - Country:US
Mailing Address - Phone:303-317-4448
Mailing Address - Fax:720-845-0880
Practice Address - Street 1:2260 S XANADU WAY STE 210
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-6557
Practice Address - Country:US
Practice Address - Phone:303-317-4448
Practice Address - Fax:720-845-0880
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOLO 5, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04N5JKOtherHOME CARE LICENSE