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Organization
COLORADO FAMILY QUALITY HOME CARE
Active
Organization
COLORADO FAMILY QUALITY HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMA KOOMSON REGISTERED NURSE (ADMINISTRATOR)
(303) 632-7225
Entity
Organization
Contact information
Practice address
1450 S HAVANA ST, SUITE410, AURORA, CO 80012-4018
(720) 296-4293
(303) 632-7225
Mailing address
1450 S HAVANA ST STE 410, AURORA, CO 80012-4025
(720) 296-4293
(303) 632-7225
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
04J169
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04J169
MEDICARE
CO
05
—
04U759
—
CO
05
—
39262006
—
CO
Enumeration date
12/16/2014
Last updated
11/02/2023
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