Organization
PRIMARY HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEWEL MARIE DENSFORD R.N. (ADMINISTRATOR)
(719) 542-7141
Entity
Organization
Contact information
Practice address
513 BROADWAY AVE, PUEBLO, CO 81004-2115
(719) 542-7141
(719) 543-5644
Mailing address
513 BROADWAY AVE, PUEBLO, CO 81004-2115
(719) 542-7141
(719) 543-5644
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CO
Other
Enumeration date
02/07/2006
Last updated
08/22/2020
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