Provider Demographics
NPI:1871151357
Name:LUCKY YOU HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:LUCKY YOU HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAYERA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMILOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-532-2920
Mailing Address - Street 1:17989 E DICKENSON PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-5909
Mailing Address - Country:US
Mailing Address - Phone:720-532-2920
Mailing Address - Fax:
Practice Address - Street 1:1602 S PARKER RD STE 308
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2922
Practice Address - Country:US
Practice Address - Phone:720-532-2920
Practice Address - Fax:720-282-3337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO97306541Medicaid
CO1679926570Medicaid
CO1598118390Medicaid