Organization
NORTH COLORADO BEHAVIORAL HEALTH OF FORT COLLINS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWENDOLYN P. ANDERSON RN (FACILITY ADMINISTRATOR)
(970) 224-0495
Entity
Organization
Contact information
Practice address
3825 E MULBERRY ST, UNIT 5C, FORT COLLINS, CO 80524-8574
(970) 224-0495
(970) 224-0497
Mailing address
3825 E MULBERRY ST, UNIT 5C, FORT COLLINS, CO 80524-8574
(970) 224-0495
(970) 224-0497
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1579-01
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
98323032
—
CO
Enumeration date
03/01/2007
Last updated
08/22/2020
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