SECOND HOME LLC (NPI# 1780158691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780158691 |
| Entity Type | Organization |
| Organization Name | SECOND HOME LLC |
| Practice Address |
550 S Academy Blvd Colorado Springs CO 80910-2636 |
| Practice Telephone | 7193758121 |
| Practice Fax Number | 7193758265 |
| Mailing Telephone | 7193758121 |
| Mailing Fax Number | 7193758265 |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-11-04 |
| Authorized Official Name | GURGEN KRYLOV (MEMBER) |
| Authorized Official Telephone | 7204487406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679115281 | Second Home LLC | Non-emergency Medical Transport (VAN) | 550 S Academy Blvd, Colorado Springs, CO 80910-2636 | 2019-10-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Second Home LLC | 61 Wetmore Avenue, Winsted, CT 06098 |
| Street Address |
550 S ACADEMY BLVD |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80910-2636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679115281 | Second Home LLC | Non-emergency Medical Transport (VAN) | 550 S Academy Blvd, Colorado Springs, CO 80910-2636 | 2019-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952955403 | Marian Lin Mondy | Social Worker | 2909 Wellshire Blvd., Colorado Springs, CO 80910 | 2019-08-01 |
| 1538727474 | Lisa Morales | Audiologist | 3225 International Cir Ste 102, Colorado Springs, CO 80910 | 2019-06-05 |
| 1134617038 | Paul Gross | Counselor | 411 Lakewood Circle Dr, C-204-b, Colorado Springs, CO 80910 | 2018-04-25 |
| 1821502923 | Kathleen Lubos Ambros-dahilig | Dental Assistant | 2240 Gilpin Ave, Colorado Springs, CO 80910 | 2017-11-28 |
| 1508384793 | Shawn Maul | Registered Nurse | 115 S Parkside, Colorado Springs, CO 80910 | 2017-09-07 |
| 1376910521 | Kelley Elizabeth Smith Bouchard | Nurse Practitioner | 3225 International Circle Suite 220, Colorado Springs, CO 80910 | 2015-08-24 |
| 1619353430 | Dr. Steven Alan Gould Dds PC | Dentist | 2859 E. Fountain Blvd, Colorado Springs, CO 80910 | 2015-08-04 |
| 1881029155 | Francis Hammet | Chiropractor | 411 Lakewood Circle A1104, Colorado Springs, CO 80910 | 2013-09-05 |
| 1447697586 | Mcb Clinical Research Centers, LLC | Psychologist | 110 S. Parkside Drive, Colorado Springs, CO 80910 | 2013-05-30 |
| 1417206723 | Augustus Albert Edwards | Case Manager/Care Coordinator | 115 Parkside Drive, Colorado Springs, CO 80910 | 2012-08-31 |
| Find all providers in zip 80910 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003380387 | Angel Heart Adult Daycare, LLC | Clinic/Center | 6612 Cottonwood Grove Dr, Colorado Springs, CO 80925-1302 | 2019-01-19 |
| 1073968731 | Thomas Dale Bono | Clinic/Center | 4104 Tennyson Ave, Colorado Springs, CO 80910-2536 | 2016-05-02 |
| 1659608768 | Silver Hearts LLC | Clinic/Center | 7844 N Academy Blvd, Colorado Springs, CO 80920 | 2009-11-10 |
| 1144670738 | Tj's Safe Haven LLC | Clinic/Center | 4104 Tennyson Ave, Colorado Springs, CO 80910-2536 | 2016-06-15 |
| 1497927529 | Sterling Adult Day Services | Clinic/Center | 2233 Academy Pl, Colorado Springs, CO 80909-1696 | 2008-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629686399 | 2nd Home Adult Community Center | Clinic/Center | 2990 S Peoria St, Aurora, CO 80014-3152 | 2020-07-20 |
| 1699397901 | Mantra Adult Day Care | Clinic/Center | 10180 E Colfax Ave Ste 205, Aurora, CO 80010-5040 | 2020-05-08 |
| 1255999082 | Lucky You Adult Day Care, LLC | Clinic/Center | 638 Kalamath St, Denver, CO 80204-4425 | 2019-06-05 |
| 1760040174 | Compassion Adult Daycare | Clinic/Center | 1740 S Buckley Rd Unit 11, Aurora, CO 80017-5600 | 2019-05-31 |
| 1568026490 | Njz Memory Care, LLC | Clinic/Center | 9800 E Geddes Ave Ste 50, Englewood, CO 80112-9306 | 2019-04-25 |
| 1629534607 | Hans Adult Day Care LLC | Clinic/Center | 911 S Havana St Ste A, Aurora, CO 80012-3034 | 2019-02-14 |
| 1144792912 | Denver Senior Care | Clinic/Center | 1427 S Federal Blvd, Denver, CO 80219-4720 | 2018-12-18 |
| 1144795154 | Prestige Adult Day Care LLC | Clinic/Center | 2860 S Havana St, Unit C, Aurora, CO 80014 | 2018-10-05 |
| 1073098539 | Hilltop Health Services Corporation | Clinic/Center | 200 S Uncompahgre Ave, Montrose, CO 81401-4260 | 2018-10-01 |
| 1831604016 | Life Adult Day Care LLC | Clinic/Center | 390 S Potomac Way Ste 116, Aurora, CO 80012-1375 | 2017-12-09 |
| Find all providers with the same taxonomy | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80910 |
Please comment or provide details below to improve the information on SECOND HOME LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.