Provider Demographics
NPI:1629572748
Name:NORTHWEST COLORADO CENTER FOR INDEPENDENCE
Entity Type:Organization
Organization Name:NORTHWEST COLORADO CENTER FOR INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-871-4838
Mailing Address - Street 1:PO BOX 771475
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-1475
Mailing Address - Country:US
Mailing Address - Phone:970-871-4838
Mailing Address - Fax:970-871-4841
Practice Address - Street 1:1306 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-5030
Practice Address - Country:US
Practice Address - Phone:970-871-4838
Practice Address - Fax:970-871-4841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)