Healthcare Provider Details

I. General information

NPI: 1992389100
Provider Name (Legal Business Name): EVERSIDE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N 17TH AVE
GREELEY CO
80631-9117
US

IV. Provider business mailing address

PO BOX 1433
PORTSMOUTH NH
03802-1433
US

V. Phone/Fax

Practice location:
  • Phone: 866-808-6005
  • Fax:
Mailing address:
  • Phone: 866-808-6005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KARLA SPIVEY
Title or Position: CENTRAL SUPPORT SPECIALIST
Credential:
Phone: 866-434-3255