Provider Demographics
NPI:1912570409
Name:CASTLE ROCK HOME CARE
Entity Type:Organization
Organization Name:CASTLE ROCK HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FELTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:720-231-1999
Mailing Address - Street 1:6562 TRAPPERS TRAIL AVE
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-2760
Mailing Address - Country:US
Mailing Address - Phone:720-231-1999
Mailing Address - Fax:
Practice Address - Street 1:6562 TRAPPERS TRAIL AVE
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-2760
Practice Address - Country:US
Practice Address - Phone:720-231-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care