Provider Demographics
NPI:1306542345
Name:SOUTH METRO HOME CARE LLC
Entity type:Organization
Organization Name:SOUTH METRO HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TITEICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-779-0299
Mailing Address - Street 1:3031 CLAIRTON DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-4552
Mailing Address - Country:US
Mailing Address - Phone:720-779-0299
Mailing Address - Fax:
Practice Address - Street 1:10288 W CHATFIELD AVE STE 301
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4242
Practice Address - Country:US
Practice Address - Phone:720-779-0299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care