Organization
STILLWATER HOME CARE AGENCY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA GAVRILOV (ADMINISTRATOR)
(720) 298-9080
Entity
Organization
Contact information
Practice address
10660 E BETHANY DR, AURORA, CO 80014-2602
(303) 753-7577
(719) 466-6172
Mailing address
10660 E BETHANY DR, AURORA, CO 80014-2602
(303) 753-7577
(719) 466-6172
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17326265
—
CO
Enumeration date
08/10/2012
Last updated
11/20/2020
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