Provider Demographics
NPI:1356058481
Name:ARISE HOME HEALTH CARE INC
Entity type:Organization
Organization Name:ARISE HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURETTA
Authorized Official - Middle Name:IFEOMA
Authorized Official - Last Name:IWUALA -MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-535-4678
Mailing Address - Street 1:11059 E BETHANY DR STE 106
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2617
Mailing Address - Country:US
Mailing Address - Phone:720-535-4678
Mailing Address - Fax:720-696-6136
Practice Address - Street 1:11059 E BETHANY DR STE 106
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2617
Practice Address - Country:US
Practice Address - Phone:720-535-4678
Practice Address - Fax:720-696-6136
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARISE HOME HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000181531Medicaid