Provider Demographics
NPI:1457105207
Name:O'MALLEY HOME CARE, LLC
Entity Type:Organization
Organization Name:O'MALLEY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MELLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-326-0405
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:INDIAN HILLS
Mailing Address - State:CO
Mailing Address - Zip Code:80454-0316
Mailing Address - Country:US
Mailing Address - Phone:720-326-0405
Mailing Address - Fax:
Practice Address - Street 1:4365 PICUTIS RD
Practice Address - Street 2:
Practice Address - City:INDIAN HILLS
Practice Address - State:CO
Practice Address - Zip Code:80454-5120
Practice Address - Country:US
Practice Address - Phone:720-326-0405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care