Provider Demographics
NPI:1578038436
Name:CAPITOL PEAK HOME CARE SERVICES
Entity type:Organization
Organization Name:CAPITOL PEAK HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MLODIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-980-3067
Mailing Address - Street 1:16372 E FREMONT AVE
Mailing Address - Street 2:UNIT 11 BLDG 4
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016
Mailing Address - Country:US
Mailing Address - Phone:720-980-3067
Mailing Address - Fax:
Practice Address - Street 1:16372 E FREMONT AVE
Practice Address - Street 2:UNIT 11 BLDG 4
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016
Practice Address - Country:US
Practice Address - Phone:720-980-3067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty