Healthcare Provider Details

I. General information

NPI: 1932674306
Provider Name (Legal Business Name): OUR HOUSE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4223 S MASON ST UNIT C
FORT COLLINS CO
80525-3048
US

IV. Provider business mailing address

1609 S WAHSATCH AVE
COLORADO SPRINGS CO
80905-2339
US

V. Phone/Fax

Practice location:
  • Phone: 970-459-0735
  • Fax: 719-477-0119
Mailing address:
  • Phone: 719-271-0676
  • Fax: 719-477-0119

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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CAROL FISCHER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 719-477-0109