# KIWICARE NON MEDICAL HOMECARE AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407627151
- **Authorized official:** MRS. JACQUI SUSAN TAASE (OWNER/OPERATOR)
- **Authorized official phone:** (832) 284-3908

## Contact information

- **Practice address:** 390 INTERLOCKEN BOULEVARD SUITE 350, BROOMFIELD, CO 80021
- **Practice address phone:** (832) 284-3908
- **Mailing address:** 5100 RONALD REAGAN BLVD APT E303, JOHNSTOWN, CO 80534-6482
- **Mailing address phone:** (832) 284-3908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 01/11/2024
- **Last updated:** 01/11/2024