Provider Demographics
NPI:1285909093
Name:GIVEN' HOME HEALTH PC
Entity type:Organization
Organization Name:GIVEN' HOME HEALTH PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO, ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:970-985-4483
Mailing Address - Street 1:3198 F RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-4039
Mailing Address - Country:US
Mailing Address - Phone:970-985-4483
Mailing Address - Fax:970-985-4067
Practice Address - Street 1:3198 F RD STE 101
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-4039
Practice Address - Country:US
Practice Address - Phone:970-985-4483
Practice Address - Fax:970-985-4067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04G928251E00000X
CO04M216253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20121089383OtherSTATE OF COLORADO IDENTIFICATION NUMBER
CO17200083Medicaid
CO078410174OtherDUNS
CO04M216OtherCOLORADO DEPARTMENT OF HEALTH CLASS B SUBLICENSE
CO6RV43OtherCAGE
CO04G928OtherCOLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
CO067525Medicare Oscar/Certification