Organization Active NPI

Skyline Home Health Care, LLC

  • Home Health Agency
  • Aurora, CO
National Provider Identifier
1104334887
Registry record updated May 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SKYLINE HOME HEALTH CARE, LLC
Practice address
10800 E Bethany Dr Ste 550E
Aurora, CO 80014-2687
Phone
(720) 207-7709
NPI assigned
Jan 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2022

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

Authorized official

Name
Aibora N Mwanri
Title
Owner
Phone
(720) 207-7709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

10800 E Bethany Dr Ste 550E
Aurora, CO 80014-2687

Mailing address

23715 E Wagon Trail Ave
Aurora, CO 80016-5958
Phone (720) 207-7709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220805002640 CO Part A Provider - Home Health Agency 3274870530 Practice locations: Aurora, CO

Home health agency certification: CCN 067627

Legal name
SKYLINE HOME HEALTH CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 3, 2023
Last certification
Dec 21, 2022
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 1, 2018 in CO
Enrollment address
10800 E Bethany Dr
Ste 550E
Aurora, CO 80014-2687

Care Compare: Home health agency

Medicare Care Compare
Listed as
Skyline Home Health Care LLCCCN 067627
Ownership
Proprietary
Certified
Jan 3, 2023
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Skyline Home Health Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10800 E Bethany Dr
Ste 550E
Aurora, CO 80014
Phone (720) 207-7709

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Aibora Mwanri Individual 5% Or Greater Direct Ownership InterestOwner Apr 1, 2021 100%
W-2 Managing EmployeeAdministrator/Owner Apr 1, 2021 100%
Operational/Managerial ControlOwner/Administrator Apr 1, 2022 100%

NPI Registry JSON

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652486400000",
    "number": "1104334887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23715 E WAGON TRAIL AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165958",
            "telephone_number": "720-207-7709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 E BETHANY DR STE 550E",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800142687",
            "telephone_number": "720-207-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2022-05-14",
        "certification_date": "2022-05-14",
        "status": "A",
        "authorized_official_last_name": "MWANRI",
        "authorized_official_first_name": "AIBORA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-207-7709"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.