Provider Demographics
NPI:1588831044
Name:SEXUAL ASSAULT VICTIM ADVOCACY CENTER
Entity Type:Organization
Organization Name:SEXUAL ASSAULT VICTIM ADVOCACY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:FARREL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-472-4204
Mailing Address - Street 1:4812 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3723
Mailing Address - Country:US
Mailing Address - Phone:970-506-4059
Mailing Address - Fax:970-674-7023
Practice Address - Street 1:4812 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3723
Practice Address - Country:US
Practice Address - Phone:970-506-4059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty