Healthcare Provider Details

I. General information

NPI: 1285842930
Provider Name (Legal Business Name): BRISTLECONE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 PEAK ONE DR. SUITE 210
FRISCO CO
80443
US

IV. Provider business mailing address

PO BOX 1327
FRISCO CO
80443-1327
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-5604
  • Fax: 970-668-3189
Mailing address:
  • Phone: 970-668-5604
  • Fax: 970-668-3189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number04141271
License Number StateCO

VIII. Authorized Official

Name: NOREEN GALABA
Title or Position: EXECUTIVE DIRECTOR
Credential: R.N.
Phone: 970-668-5604