Provider Demographics
NPI:1881254803
Name:TETRANS HOME CARE LLC
Entity type:Organization
Organization Name:TETRANS HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:WANI
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-337-4920
Mailing Address - Street 1:3000 S JAMAICA CT STE 275
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4604
Mailing Address - Country:US
Mailing Address - Phone:303-337-4920
Mailing Address - Fax:303-337-2025
Practice Address - Street 1:3000 S JAMAICA CT STE 275
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4604
Practice Address - Country:US
Practice Address - Phone:303-337-4920
Practice Address - Fax:303-337-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000146693Medicaid