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General NPI Number Information
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NPI Number | 1497874200
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Entity Type | Organization
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Legal Business Name | NAMAQUA CENTER
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 404 E 7TH ST
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City | LOVELAND
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State | CO
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Zip | 80537-4804
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Country | US
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Telephone | 970-669-7550
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Fax | 970-663-2907
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Provider Business Mailing Address
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Address Line | 404 E 7TH ST
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City | LOVELAND
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State | CO
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Zip | 80537-4804
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Country | US
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Telephone | 970-669-7550
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Fax | 970-663-2907
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. CYNDI DODDS
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Credential | LMFT
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Telephone | 970-690-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 100889
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 45142
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License Number State | CO
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