Healthcare Provider Details

I. General information

NPI: 1043075443
Provider Name (Legal Business Name): FORWARD HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 1ST AVE #6
LONGMONT CO
80501
US

IV. Provider business mailing address

335 1ST AVE # 6
LONGMONT CO
80501-5958
US

V. Phone/Fax

Practice location:
  • Phone: 303-381-3097
  • Fax:
Mailing address:
  • Phone: 303-381-3097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC CRAIG NAKAYAMA
Title or Position: PRESIDENT
Credential:
Phone: 303-381-3097