Organization
ISLAND GROVE REGIONAL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENDALL P ALEXANDER MSW (EXECUTIVE DIRECTOR)
(970) 356-6664
Entity
Organization
Contact information
Practice address
212 W MOUNTAIN AVENUE, FT COLLINS, CO 80521
(970) 493-1157
(970) 224-9606
Mailing address
212 W MOUNTAIN AVENUE, FT COLLINS, CO 80521
(970) 493-1157
(970) 224-9606
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
105104
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75753766
—
CO
Enumeration date
02/01/2008
Last updated
02/01/2008
Update your record
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