1972970622 NPI number — ARISE HOME HEALTH CARE INC

Table of content: (NPI 1972970622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972970622 NPI number — ARISE HOME HEALTH CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARISE HOME HEALTH CARE INC
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:
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:
1972970622
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/01/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2323 S TROY ST
Provider Second Line Business Mailing Address:
BUILDING 1 STE 225
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80014-1946
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-535-4678
Provider Business Mailing Address Fax Number:
720-696-6135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2323 S TROY ST
Provider Second Line Business Practice Location Address:
BUILDING 1 225
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80014-1946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-535-4678
Provider Business Practice Location Address Fax Number:
720-696-6135
Provider Enumeration Date:
08/28/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
IWUALA MCWILLIAMS
Authorized Official First Name:
LAURETTA
Authorized Official Middle Name:
IFEOMA
Authorized Official Title or Position:
CEO/ADMINISTRATOR
Authorized Official Telephone Number:
720-260-2718

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  04L191 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251J00000X , with the licence number: 04L191 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 04L191 , 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)