Provider Demographics
NPI:1265539530
Name:ADULT HOME CARE SERVICES, INC.
Entity type:Organization
Organization Name:ADULT HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-874-0136
Mailing Address - Street 1:550 PALMER ST STE 102
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-1720
Mailing Address - Country:US
Mailing Address - Phone:970-874-0136
Mailing Address - Fax:970-874-1827
Practice Address - Street 1:550 PALMER ST STE 102
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-1720
Practice Address - Country:US
Practice Address - Phone:970-874-0136
Practice Address - Fax:970-874-1827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04138624Medicaid