Healthcare Provider Details

I. General information

NPI: 1982799383
Provider Name (Legal Business Name): HANLON-BUSH INVESTMENTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 PATTON STREET
FORT COLLINS CO
80524-4018
US

IV. Provider business mailing address

1020 PATTON ST
FORT COLLINS CO
80524-4018
US

V. Phone/Fax

Practice location:
  • Phone: 970-484-7981
  • Fax: 970-484-8103
Mailing address:
  • Phone: 970-484-7981
  • Fax: 970-484-8143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1246
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number1246
License Number StateCO

VIII. Authorized Official

Name: ANTHONY JOHN HANLON
Title or Position: ADMINISTRATOR
Credential:
Phone: 970-484-7981