Provider Demographics
NPI:1568194223
Name:ALDER GROVE HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:ALDER GROVE HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:720-331-6899
Mailing Address - Street 1:90 MADISON ST STE 302
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5412
Mailing Address - Country:US
Mailing Address - Phone:720-331-6899
Mailing Address - Fax:720-306-5499
Practice Address - Street 1:343 W DRAKE RD STE 200
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2880
Practice Address - Country:US
Practice Address - Phone:720-331-6899
Practice Address - Fax:720-306-5499
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALDER GROVE HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty