- Enrollment id
- O20030826000020
- Enrollment state
- CO
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1609863984
- Multiple npi flag
- N
- Ccn
- 067201
- Associate id
- 4789595158
- Organization name
- SCL FRONT RANGE HOME HEALTH LLC
- Doing business as name
- INTERMOUNTAIN HEALTH HOMECARE - DENVER
- Incorporation date
- 1992-01-23
- Incorporation state
- CO
- Organization type structure
- LLC
- Proprietary nonprofit
- N
- Address line 1
- 1960 N OGDEN ST
- Address line 2
- STE 280
- City
- DENVER
- State
- CO
- Zip code
- 802183664