Provider Demographics
NPI:1861097982
Name:ABODE HEALTHCARE COLORADO, INC
Entity type:Organization
Organization Name:ABODE HEALTHCARE COLORADO, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-810-1079
Mailing Address - Street 1:1050 EAGLERIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-2130
Mailing Address - Country:US
Mailing Address - Phone:719-600-2231
Mailing Address - Fax:
Practice Address - Street 1:1050 EAGLERIDGE BLVD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2130
Practice Address - Country:US
Practice Address - Phone:719-600-2231
Practice Address - Fax:719-600-2232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABODE HEALTHCARE COLORADO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-04
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based