Healthcare Provider Details

I. General information

NPI: 1598671943
Provider Name (Legal Business Name): OTHERWISE LIMITED FARM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2127 W COUNTY ROAD 38 E
FORT COLLINS CO
80526-5324
US

IV. Provider business mailing address

2127 W COUNTY ROAD 38 E
FORT COLLINS CO
80526-5324
US

V. Phone/Fax

Practice location:
  • Phone: 970-310-0369
  • Fax:
Mailing address:
  • Phone: 970-310-0369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: AUDREY HENDRICKS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 970-310-0369