National Provider Identifier Database

ISLAND GROVE REGIONAL TREATMENT CENTER
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

ISLAND GROVE REGIONAL TREATMENT CENTER
212 W MOUNTAIN AVENUE
FORT COLLINS, CO80521
Phone: 970-493-1157
Fax: 970-224-9606
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for ISLAND GROVE REGIONAL TREATMENT CENTER

NPI Number 1194903153
Legal business name
LBN
ISLAND GROVE REGIONAL TREATMENT CENTER
Authorized official KENDALL ALEXANDER - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 02/01/2008
Last updated 02/01/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • CO License #: 105104
  • CO Medicaid: 75753766

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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