- Enrollment id
- O20170817003312
- Enrollment state
- CO
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1184164436
- Multiple npi flag
- N
- Ccn
- 067566
- Associate id
- 0840562344
- Organization name
- ANGELS OF CARE PEDIATRIC HOME HEALTH COLORADO LLC
- Doing business as name
- ANGELS OF CARE PEDIATRIC HOME HEALTH
- Incorporation date
- 2017-02-10
- Incorporation state
- CO
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2851 S PARKER RD
- Address line 2
- STE 1136
- City
- AURORA
- State
- CO
- Zip code
- 800142732