Provider Demographics
NPI:1942669692
Name:ENVISION HOSPICE OF COLORADO LLC
Entity Type:Organization
Organization Name:ENVISION HOSPICE OF COLORADO LLC
Other - Org Name:ENVISION HEALTHCARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-900-3505
Mailing Address - Street 1:1345 W 1600 N
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2431
Mailing Address - Country:US
Mailing Address - Phone:801-225-7971
Mailing Address - Fax:855-551-5516
Practice Address - Street 1:1720 S BELLAIRE ST STE 308
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4304
Practice Address - Country:US
Practice Address - Phone:720-900-3505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000154239Medicaid