Provider Demographics
NPI:1124531637
Name:TEAMWORK NETWORKING LLC
Entity type:Organization
Organization Name:TEAMWORK NETWORKING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AGENCY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEHLIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-274-9965
Mailing Address - Street 1:685 MAIN ST,
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MEEKER
Mailing Address - State:CO
Mailing Address - Zip Code:81641
Mailing Address - Country:US
Mailing Address - Phone:970-274-9965
Mailing Address - Fax:
Practice Address - Street 1:685 MAIN ST,
Practice Address - Street 2:SUITE 5
Practice Address - City:MEEKER
Practice Address - State:CO
Practice Address - Zip Code:81641
Practice Address - Country:US
Practice Address - Phone:970-274-9965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
CO04Y769385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04Y769OtherNON MEDICAL AGENCY LICENSE