Provider Demographics
NPI:1952049165
Name:HOMETOWN RESPITE, INC.
Entity Type:Organization
Organization Name:HOMETOWN RESPITE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:DARIN
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:ESQUIRE
Authorized Official - Phone:719-648-7532
Mailing Address - Street 1:534 CHATFIELD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-1710
Mailing Address - Country:US
Mailing Address - Phone:719-648-7532
Mailing Address - Fax:719-634-8535
Practice Address - Street 1:320 S CASCADE AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3814
Practice Address - Country:US
Practice Address - Phone:719-648-7532
Practice Address - Fax:719-634-8535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care