1346481710 NPI number — EH HOME HEALTH OF COLORADO LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346481710 NPI number — EH HOME HEALTH OF COLORADO LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EH HOME HEALTH OF COLORADO 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:
Provider Other Organization Name Type Code:
6
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:
1346481710
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6688 N CENTRAL EXPY
Provider Second Line Business Mailing Address:
SUITE 1300
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75206-3950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-239-6500
Provider Business Mailing Address Fax Number:
214-239-6581

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
910 PINON RANCH VIEW
Provider Second Line Business Practice Location Address:
SUITE 211, BLDG 4, UNIT A
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-265-6931
Provider Business Practice Location Address Fax Number:
719-265-6934
Provider Enumeration Date:
03/16/2009

Additional Information

Authorized Official

Authorized Official Last Name:
JOLLEY
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
DIANE
Authorized Official Title or Position:
EVP OF HOME HEALTH OPERATIONS
Authorized Official Telephone Number:
214-239-6500

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  04Q268 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 89270762 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06D1037068 . This is a "CLIA" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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