Provider Demographics
NPI:1225528151
Name:NORTHWEST COLORADO VISITING NURSE ASSOCIATION
Entity Type:Organization
Organization Name:NORTHWEST COLORADO VISITING NURSE ASSOCIATION
Other - Org Name:NORTHWEST COLORADO HEALTH DENTAL CLINIC - SOUTH ROUTT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-871-7635
Mailing Address - Street 1:745 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2019
Mailing Address - Country:US
Mailing Address - Phone:970-824-8233
Mailing Address - Fax:970-824-6184
Practice Address - Street 1:300 MAIN STREET
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:CO
Practice Address - Zip Code:80467
Practice Address - Country:US
Practice Address - Phone:970-824-8000
Practice Address - Fax:970-824-1179
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST COLORADO VISITING NURSE ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-16
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental