Provider Demographics
NPI:1205655636
Name:CC HOME CARE LLC
Entity type:Organization
Organization Name:CC HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DAHLQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:DSW
Authorized Official - Phone:303-389-5700
Mailing Address - Street 1:2095 S PONTIAC WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2411
Mailing Address - Country:US
Mailing Address - Phone:303-389-5700
Mailing Address - Fax:303-389-5708
Practice Address - Street 1:2095 S PONTIAC WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2411
Practice Address - Country:US
Practice Address - Phone:303-389-5700
Practice Address - Fax:303-389-5708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care