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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 Specialty Code Provider Type

Substance Abuse Disorder Rehabilitation Facility

324500000X
Indicates primary specialty

NPI Profile & details for ISLAND GROVE REGIONAL TREATMENT CENTER

NPI Number 1194903153
LBN Legal business name ISLAND GROVE REGIONAL TREATMENT CENTER
Authorized official KENDALL ALEXANDER - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/01/2008
Last updated 02/01/2008 - About 18 years ago
Identifiers
CO License # 105104
CO Medicaid 75753766
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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