Organization
ELDERHAUS ADULT DAY PROGRAM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE R VANDE WALLE (EXECUTIVE DIRECTOR)
(970) 221-0406
Entity
Organization
Contact information
Practice address
6813 S COLLEGE AVE, FORT COLLINS, CO 80525-4144
(970) 221-0406
Mailing address
6813 S COLLEGE AVE, FORT COLLINS, CO 80525-4144
(970) 221-0406
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04000790
—
CO
05
—
61522562
—
CO
Enumeration date
07/15/2015
Last updated
02/01/2017
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