Healthcare Provider Details

I. General information

NPI: 1528081023
Provider Name (Legal Business Name): LONGMONT UNITED HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 MOUNTAIN VIEW AVE
LONGMONT CO
80501-3129
US

IV. Provider business mailing address

1950 W MOUNTAIN VIEW AVE
LONGMONT CO
80501-3129
US

V. Phone/Fax

Practice location:
  • Phone: 303-651-5111
  • Fax: 303-651-5268
Mailing address:
  • Phone: 303-651-5111
  • Fax: 303-651-5268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MR. MITCHELL CARSON
Title or Position: CEO
Credential:
Phone: 303-651-5024