Provider Demographics
NPI:1598411969
Name:HOME CARE RN INC
Entity type:Organization
Organization Name:HOME CARE RN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARAT
Authorized Official - Middle Name:
Authorized Official - Last Name:GESELKOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-549-0822
Mailing Address - Street 1:1325 S COLORADO BLVD # B101
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3303
Mailing Address - Country:US
Mailing Address - Phone:720-535-8652
Mailing Address - Fax:
Practice Address - Street 1:1325 S COLORADO BLVD # B101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3303
Practice Address - Country:US
Practice Address - Phone:720-535-8652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO31600280Medicaid