Healthcare Provider Details

I. General information

NPI: 1619674165
Provider Name (Legal Business Name): NORTHWEST COLORADO CENTER FOR INDEPENDENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 SHIELD DR UNIT 300
STEAMBOAT SPRINGS CO
80487-5247
US

IV. Provider business mailing address

1855 SHIELD DR UNIT 300
STEAMBOAT SPRINGS CO
80487-5247
US

V. Phone/Fax

Practice location:
  • Phone: 970-871-4838
  • Fax: 970-871-4841
Mailing address:
  • Phone: 970-871-4838
  • Fax: 970-871-4841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: IAN ENGLE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-720-9405