Organization
PHHC ACQUISITION CORP.
Active
Other names
CenterWell Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED OFFICIAL)
(719) 583-0832
Entity
Organization
Contact information
Practice address
1315 FORTINO BLVD STE A, PUEBLO, CO 81008-1982
(719) 583-0832
(719) 583-0849
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
(913) 814-4843
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040504
STATE LICENSE
CO
Enumeration date
01/08/2021
Last updated
11/30/2023
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