Organization
INTERIM HEALTHCARE OF FORT COLLINS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGY BLOMBERG (ADMINISTRATOR)
(970) 472-4180
Entity
Organization
Contact information
Practice address
2000 VERMONT DR, SUITE 100, FORT COLLINS, CO 80525-2900
(970) 472-4180
(970) 472-4183
Mailing address
2000 VERMONT DR, SUITE 100, FORT COLLINS, CO 80525-2900
(970) 472-4180
(970) 472-4183
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
1003YH
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0403FH
STATE LICENSE CLASS A MEDICAL
CO
05
—
05701297
—
CO
01
—
1003YH
STATE LICENSE CLASS B NON-MEDICAL
CO
Enumeration date
03/02/2006
Last updated
02/23/2016
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