Organization
CHARTER HEALTHCARE OF NORTHERN COLORADO, LLC
Active
Other names
Phoenix Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIE BOAL (COMPLIANCE)
(909) 644-4965
Entity
Organization
Contact information
Practice address
1562 TAURUS CT, LOVELAND, CO 80537-3280
(970) 667-2273
(888) 891-0585
Mailing address
1562 TAURUS CT, LOVELAND, CO 80537-3280
(970) 667-2273
(888) 891-0585
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
04Z780
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000146914
—
CO
Enumeration date
03/16/2018
Last updated
04/28/2022
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