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06D2034295 CLIA NUMBER - EVERGREEN HOME HEALTHCARE, LLC DBA - AVEANNA HEALTHCARE

Laboratory Demographics

CLIA Number: 06D2034295

Facility Name: EVERGREEN HOME HEALTHCARE, LLC DBA - AVEANNA HEALTHCARE

Facility Address:
1235 WEST 124TH AVE, SUITE 102
WESTMINSTER, CO
ZIP 80234
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Facility Phone Number: 303 920-0818

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1285290510

Taxonomy: 253Z00000X - In Home Supportive Care
An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.

CLIA Record

Field Name Field Value
CLIA Number 06D2034295
LAB Type Home Health Agency
Facility Name EVERGREEN HOME HEALTHCARE, LLC DBA - AVEANNA HEALTHCARE
Street 1235 WEST 124TH AVE, SUITE 102
City WESTMINSTER
State CO
ZIP 80234
Phone 303 920-0818
CertificateType 4
CertificateEffectiveDate 12/20/2023
CertificateExpirationDate 12/19/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024