Healthcare Provider Details

I. General information

NPI: 1104637362
Provider Name (Legal Business Name): WELLS HEALTHCARE FOUNDATION AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 BOISE AVE STE 203C
LOVELAND CO
80538-4247
US

IV. Provider business mailing address

1530 BOISE AVE STE 203C
LOVELAND CO
80538-4247
US

V. Phone/Fax

Practice location:
  • Phone: 267-366-7897
  • Fax:
Mailing address:
  • Phone: 267-366-7897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: LENEST DUNBAR
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 267-366-7897