Provider Demographics
NPI: | 1285411413 |
---|---|
Name: | ORCHARD HOME HEALTH CARE LLC |
Entity type: | Organization |
Organization Name: | ORCHARD HOME HEALTH CARE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR OF NURSING |
Authorized Official - Prefix: | |
Authorized Official - First Name: | YEMESRACH |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MAKONNEN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN BSN |
Authorized Official - Phone: | 720-937-3876 |
Mailing Address - Street 1: | 6343 S JACKSON GAP CT |
Mailing Address - Street 2: | |
Mailing Address - City: | AURORA |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80016-2465 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6343 S JACKSON GAP CT |
Practice Address - Street 2: | |
Practice Address - City: | AURORA |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80016-2465 |
Practice Address - Country: | US |
Practice Address - Phone: | 720-937-3876 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-09-12 |
Last Update Date: | 2024-07-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care | Group - Single Specialty | |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty |