Centennial SHC, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

04P890 Issued in CO

Legal business name

CENTENNIAL SHC, LLC

Doing business as

Safe Homecare

Practice address

3033 S Parker Rd
Ste. 220
Aurora, CO 80014-2910

Phone

(720) 242-7959

NPI assigned

Apr 6, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adam Krueger

Title

Chief Operating Officer

Phone

(720) 242-7959

Specialties & licenses 1

Addresses

Other names 1

• SAFE HOMECARE Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1013440080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 S PARKER RD",
            "address_2": "STE. 220",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142910",
            "telephone_number": "720-242-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 S PARKER RD",
            "address_2": "STE. 220",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142910",
            "telephone_number": "720-242-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL SHC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "720-242-7959"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CO",
            "license": "04P890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAFE HOMECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.