Provider Demographics
NPI:1912377599
Name:FOOTSTOOL CARE LLC
Entity Type:Organization
Organization Name:FOOTSTOOL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GANGDIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-275-8253
Mailing Address - Street 1:2600 S PARKER RD BUILDING 1-118
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014
Mailing Address - Country:US
Mailing Address - Phone:720-253-0647
Mailing Address - Fax:
Practice Address - Street 1:2600 S PARKER RD BUILDING 1-118
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014
Practice Address - Country:US
Practice Address - Phone:720-253-0647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04Q653251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health