MEDICARE: HOMEWARD ALLIANCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1376380626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMEWARD ALLIANCE

Provider Business Mailing Address
First Line	:	242 CONIFER ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-2043
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3750 S MASON ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-4574
Country	:	US
Telephone Number	:	970-829-4660
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DAVID ROUT
Credential	:
Telephone Number	:	970-682-3193

Provider Enumeration Date	:	07/12/2024
Last Update Date	:	07/12/2024

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Directions to “HOMEWARD ALLIANCE ” Practice Location

Language	Start Address	Practice Location

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