Provider Demographics
NPI:1336264720
Name:PROFESSIONAL HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:PROFESSIONAL HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-530-5492
Mailing Address - Street 1:1629 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-2219
Mailing Address - Country:US
Mailing Address - Phone:720-494-0190
Mailing Address - Fax:720-864-2839
Practice Address - Street 1:1424 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3714
Practice Address - Country:US
Practice Address - Phone:719-542-7901
Practice Address - Fax:719-542-5794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04138020OtherOTHER HCBS DE