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CENTENNIAL HOME CARE LLC NPI 1780724559


NPI Information

NPI: 1780724559
Provider Name: CENTENNIAL HOME CARE, LLC

Doing Business As: MEMORIAL REGIONAL HEALTH HOME HEALTH AND HOSPICE

Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 06D1096191

Address:
600 RUSSELL ST
CRAIG, CO
ZIP 81625
Phone: (970) 824-6882
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CENTENNIAL HOME CARE, LLC is a home health in Craig, CO. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. CENTENNIAL HOME CARE, LLC NPI is 1780724559. The provider is registered as an organization entity type.
The provider Is Doing Business As Memorial Regional Health Home Health And Hospice.

The provider's business location address is:

600 RUSSELL ST
CRAIG, CO
ZIP 81625-018
Phone: (970) 824-6882
Fax: (970) 824-2157

The provider's authorized official is Kristine Cooper .
The authorized official title is Director and has the following contact phone number (970) 826-2421.

The CLIA number assigned to this NPI record is 06D1096191 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/8/2007 and was last updated on 7/19/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome Health06D1019559COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
179873341MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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