1134872450 NPI number — 3AHC21 LLC

Table of content: (NPI 1134872450)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134872450 NPI number — 3AHC21 LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
3AHC21 LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VISITING ANGELS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134872450
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26 W DRY CREEK CIR STE 820
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80120-8038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-981-0804
Provider Business Mailing Address Fax Number:
720-981-8443

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26 W DRY CREEK CIR STE 820
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80120-8038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-981-0804
Provider Business Practice Location Address Fax Number:
720-981-8443
Provider Enumeration Date:
01/27/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GUERRERO
Authorized Official First Name:
PETER
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
720-981-0804

Provider Taxonomy Codes

  • Taxonomy code: 172A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)