Provider Demographics
NPI:1841468071
Name:SUNRISE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:SUNRISE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:KAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-873-1000
Mailing Address - Street 1:3033 S PARKER RD STE 208
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2915
Mailing Address - Country:US
Mailing Address - Phone:303-873-1000
Mailing Address - Fax:303-369-2399
Practice Address - Street 1:3033 S PARKER RD STE 208
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2915
Practice Address - Country:US
Practice Address - Phone:303-873-1000
Practice Address - Fax:303-369-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04T307OtherLICENSE
CO33785350Medicaid
CO04T307OtherLICENSE