Provider Demographics
NPI:1104441690
Name:WRIGHT CARE HOME, LLC
Entity type:Organization
Organization Name:WRIGHT CARE HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENTIAL HOME OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:720-609-9259
Mailing Address - Street 1:4822 KIRK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-7477
Mailing Address - Country:US
Mailing Address - Phone:720-609-9259
Mailing Address - Fax:
Practice Address - Street 1:4822 KIRK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-7477
Practice Address - Country:US
Practice Address - Phone:720-609-9259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1952562928Medicaid