Organization
COLUMBINE POUDRE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J. ROBERT WILSON (OWNER)
(970) 482-0198
Entity
Organization
Contact information
Practice address
915 CENTRE AVE, SUITE 2, FORT COLLINS, CO 80526-6045
(970) 482-5096
(970) 224-2518
Mailing address
915 CENTRE AVE, SUITE 2, FORT COLLINS, CO 80526-6045
(970) 482-5096
(970) 224-2518
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29286573
—
CO
05
—
36373036
—
CO
01
—
638551
BCBS PROVIDER #
—
Enumeration date
07/14/2005
Last updated
11/12/2025
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