# NORTH COLORADO BEHAVIORAL HEALTH OF FORT COLLINS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730217787
- **Authorized official:** MS. GWENDOLYN P. ANDERSON RN (FACILITY ADMINISTRATOR)
- **Authorized official phone:** (970) 224-0495

## Contact information

- **Practice address:** 3825 E MULBERRY ST, UNIT 5C, FORT COLLINS, CO 80524-8574
- **Practice address phone:** (970) 224-0495
- **Practice address fax:** (970) 224-0497
- **Mailing address:** 3825 E MULBERRY ST, UNIT 5C, FORT COLLINS, CO 80524-8574
- **Mailing address phone:** (970) 224-0495
- **Mailing address fax:** (970) 224-0497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 1579-01 | CO | Yes |

## Other

- **Enumeration date:** 03/01/2007
- **Last updated:** 08/22/2020