1669615688 NPI number — THE DACCARDI CENTER FOR NATURAL HEALTH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669615688 NPI number — THE DACCARDI CENTER FOR NATURAL HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE DACCARDI CENTER FOR NATURAL HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HEARTHSTONE INTEGRATED NATURAL HEALTH, PAIN CENTER AT HEARTHSTONE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669615688
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1939 WILMINGTON DR
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
FORT COLLINS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80528-6404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-224-2261
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1939 WILMINGTON DR
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
FORT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80528-6404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-224-2261
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/07/2009

Additional Information

Authorized Official

Authorized Official Last Name:
DACCARDI
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
LEONARD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
970-224-2261

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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