Provider Demographics
NPI:1013908250
Name:ICON HOME HEALTH, LLC
Entity Type:Organization
Organization Name:ICON HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-234-9500
Mailing Address - Street 1:7000 W 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4723
Mailing Address - Country:US
Mailing Address - Phone:303-234-9500
Mailing Address - Fax:303-237-3907
Practice Address - Street 1:7000 W 14TH AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-4723
Practice Address - Country:US
Practice Address - Phone:303-234-9500
Practice Address - Fax:303-237-3907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO=========OtherTIN
CO067181AMedicare Oscar/Certification