Provider Demographics
NPI:1417747650
Name:INTEGRATED HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:INTEGRATED HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIAMAWIT
Authorized Official - Middle Name:
Authorized Official - Last Name:DESTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-770-1725
Mailing Address - Street 1:7565 S FRANKLIN WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:562 SABLE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-0809
Practice Address - Country:US
Practice Address - Phone:720-770-1725
Practice Address - Fax:720-343-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care