Provider Demographics
NPI:1043030216
Name:1 MILE HIGH SENIOR HOME CARE LLC
Entity type:Organization
Organization Name:1 MILE HIGH SENIOR HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ZINEB
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUAYAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-938-0470
Mailing Address - Street 1:6740 TREMOLITE DR
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-7535
Mailing Address - Country:US
Mailing Address - Phone:720-938-0470
Mailing Address - Fax:
Practice Address - Street 1:6740 TREMOLITE DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-7535
Practice Address - Country:US
Practice Address - Phone:720-938-0470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health