Provider Demographics
NPI:1356010078
Name:ADDIS HOME HEALTH CARE
Entity type:Organization
Organization Name:ADDIS HOME HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMARE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEREMEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-886-8894
Mailing Address - Street 1:1010 S JOLIET ST STE 101
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3150
Mailing Address - Country:US
Mailing Address - Phone:303-337-7799
Mailing Address - Fax:303-337-0017
Practice Address - Street 1:1010 S JOLIET ST STE 101
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3150
Practice Address - Country:US
Practice Address - Phone:303-337-7799
Practice Address - Fax:303-337-0017
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADDIS HOME HEALTH CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-07
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health