MEDICARE: JACOB FAMILY SERVICES, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	71260	CO

General Provider Information

NPI Number	:	1649302852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACOB FAMILY SERVICES, INC.

Provider Business Mailing Address
First Line	:	729 REMINGTON ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3332
Country	:	US
Telephone Number	:	970-484-8427
Fax Number	:	970-482-0713

Provider Business Practice Location Address
First Line	:	729 REMINGTON ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3332
Country	:	US
Telephone Number	:	970-484-8427
Fax Number	:	970-482-8713

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JOEL DAVID PAINTER
Credential	:	MA, LPC, CAC III
Telephone Number	:	970-484-8427

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/09/2025

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