Provider Demographics
NPI:1740719673
Name:SUMMIT HOME CARE INC
Entity type:Organization
Organization Name:SUMMIT HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GULCHEHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCHAKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-261-6324
Mailing Address - Street 1:2851 S PARKER RD STE 978
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2804
Mailing Address - Country:US
Mailing Address - Phone:303-955-4133
Mailing Address - Fax:303-955-8491
Practice Address - Street 1:2851 S PARKER RD STE 978
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2804
Practice Address - Country:US
Practice Address - Phone:303-955-4133
Practice Address - Fax:303-955-8491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO253Z00000X, 3747P1801X, 376J00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty