Provider Demographics
NPI:1295515690
Name:HESED SERVICES, LLC
Entity type:Organization
Organization Name:HESED SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:RUSTY
Authorized Official - Middle Name:
Authorized Official - Last Name:THULIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-204-9466
Mailing Address - Street 1:4035 DEER VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-9222
Mailing Address - Country:US
Mailing Address - Phone:303-204-9466
Mailing Address - Fax:
Practice Address - Street 1:4035 DEER VALLEY CT
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9222
Practice Address - Country:US
Practice Address - Phone:303-204-9466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care