Provider Demographics
NPI:1124803747
Name:EMARALD GLORY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:EMARALD GLORY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING (DON)
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:IWAGBEMI
Authorized Official - Last Name:DADA
Authorized Official - Suffix:
Authorized Official - Credentials:RN/BSN
Authorized Official - Phone:720-277-6145
Mailing Address - Street 1:4809 ARGONNE ST STE 155
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-6834
Mailing Address - Country:US
Mailing Address - Phone:720-277-6145
Mailing Address - Fax:720-583-0326
Practice Address - Street 1:4809 ARGONNE ST STE 155
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-6834
Practice Address - Country:US
Practice Address - Phone:720-277-6145
Practice Address - Fax:720-583-0326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty