MEDICARE: LITTLE BEAR & CO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	253J00000X	Foster Care Agency
3	385H00000X	Respite Care
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1265159883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE BEAR & CO LLC

Provider Business Mailing Address
First Line	:	4709 SPRINGER DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-8926
Country	:	US
Telephone Number	:	970-405-0582
Fax Number	:

Provider Business Practice Location Address
First Line	:	4709 SPRINGER DR
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-8926
Country	:	US
Telephone Number	:	970-405-0582
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	NYCOLE S VANWHYE
Credential	:
Telephone Number	:	970-405-0582

Provider Enumeration Date	:	10/25/2022
Last Update Date	:	10/25/2022

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Directions to “LITTLE BEAR & CO LLC ” Practice Location

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