Individual
JASON LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4856 INNOVATION DR, FORT COLLINS, CO 80525-5539
(970) 494-4200
(844) 270-1824
Mailing address
4856 INNOVATION DR, FORT COLLINS, CO 80525-5539
(970) 494-4200
(844) 270-1824
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACA.0008361
CO
171M00000X
Case Manager/Care Coordinator
—
—
172A00000X
Driver
—
—
Other
Enumeration date
09/19/2019
Last updated
03/03/2026
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