Provider Demographics
NPI: | 1053618959 |
---|---|
Name: | HULSIZER ENTERPRISES INC |
Entity type: | Organization |
Organization Name: | HULSIZER ENTERPRISES INC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JERRY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HULSIZER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 303-953-8753 |
Mailing Address - Street 1: | 558 E CASTLE PINES PKWY |
Mailing Address - Street 2: | UNIT B-4142 |
Mailing Address - City: | CASTLE ROCK |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80108-4608 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 303-953-8753 |
Mailing Address - Fax: | 303-800-8278 |
Practice Address - Street 1: | 558 E CASTLE PINES PKWY |
Practice Address - Street 2: | UNIT B4142 |
Practice Address - City: | CASTLE ROCK |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80108-4608 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-953-8753 |
Practice Address - Fax: | 303-800-8278 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-02-12 |
Last Update Date: | 2011-02-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CO | 04X107 | 253Z00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care |