Provider Demographics
NPI:1841934387
Name:PEAKS OF HOPE HOME HEALTH, LLC
Entity type:Organization
Organization Name:PEAKS OF HOPE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN OWNER ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LIVENGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-371-0910
Mailing Address - Street 1:1661 COUNTY ROAD 170
Mailing Address - Street 2:
Mailing Address - City:WESTCLIFFE
Mailing Address - State:CO
Mailing Address - Zip Code:81252-9168
Mailing Address - Country:US
Mailing Address - Phone:719-371-0910
Mailing Address - Fax:888-898-5251
Practice Address - Street 1:1661 COUNTY ROAD 170
Practice Address - Street 2:
Practice Address - City:WESTCLIFFE
Practice Address - State:CO
Practice Address - Zip Code:81252-9168
Practice Address - Country:US
Practice Address - Phone:719-371-0910
Practice Address - Fax:888-898-5251
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEAKS OF HOPE HOME HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000198212Medicaid