Provider Demographics
NPI:1780282749
Name:JOELLA HOMECARE
Entity type:Organization
Organization Name:JOELLA HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMANUELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOAKO
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:720-257-8520
Mailing Address - Street 1:262 HAVANA ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-4351
Mailing Address - Country:US
Mailing Address - Phone:720-257-8520
Mailing Address - Fax:
Practice Address - Street 1:262 HAVANA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-4351
Practice Address - Country:US
Practice Address - Phone:720-257-8520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO94453615Medicaid