Organization
FIDEM HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH PHIRI IERVOLINO (EXECUTIVE DIRECTOR)
(720) 324-6365
Entity
Organization
Contact information
Practice address
8500 EAST MISSISSIPI AVE, UNIT 82, DENVER, CO 80247-2247
(720) 324-6365
Mailing address
8500 EAST MISSISSIPI AVE, UNIT 82, DENVER, CO 80247-2247
(720) 324-6365
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
02/03/2023
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