Healthcare Provider Details

I. General information

NPI: 1912522376
Provider Name (Legal Business Name): NORTHERN COLORADO BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 JESSUP DR FARMS
FORT COLLINS CO
80525
US

IV. Provider business mailing address

1817 JESSUP DR
FORT COLLINS CO
80525-2550
US

V. Phone/Fax

Practice location:
  • Phone: 928-925-0885
  • Fax: 866-218-5769
Mailing address:
  • Phone: 866-218-5769
  • Fax: 866-218-5769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ALTHEA HRDLICHKA
Title or Position: OWNER
Credential:
Phone: 866-218-5769