Provider Demographics
NPI:1285842930
Name:BRISTLECONE HEALTH SERVICES
Entity Type:Organization
Organization Name:BRISTLECONE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALABA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:970-668-5604
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-1327
Mailing Address - Country:US
Mailing Address - Phone:970-668-5604
Mailing Address - Fax:970-668-3189
Practice Address - Street 1:360 PEAK ONE DR.
Practice Address - Street 2:SUITE 210
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-668-5604
Practice Address - Fax:970-668-3189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04141271251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04141271OtherHCBS