Healthcare Provider Details

I. General information

NPI: 1013911437
Provider Name (Legal Business Name): NORTHEAST COLORADO HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 COLUMBINE ST
STERLING CO
80751-3728
US

IV. Provider business mailing address

700 COLUMBINE
STERLING CO
80751
US

V. Phone/Fax

Practice location:
  • Phone: 970-522-3741
  • Fax: 970-522-1412
Mailing address:
  • Phone: 970-522-3741
  • Fax: 970-522-1412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number98-05302
License Number StateCO

VIII. Authorized Official

Name: MR. JOSEPH DASSARO
Title or Position: HUMAN RESOURCE DIRECTOR
Credential: PHR
Phone: 970-522-3741