1457470031 NPI number — TURNING POINT CENTER FOR YOUTH & DEVELOP

Table of content: (NPI 1457470031)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457470031 NPI number — TURNING POINT CENTER FOR YOUTH & DEVELOP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TURNING POINT CENTER FOR YOUTH & DEVELOP
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:
TURNING POINT CENTER FOR YOUTH & DEVELOPMENT INC.
Provider Other Organization Name Type Code:
5
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:
1457470031
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1644 S COLLEGE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT COLLINS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-221-0999
Provider Business Mailing Address Fax Number:
970-221-2727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
640 W PROSPECT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-221-0999
Provider Business Practice Location Address Fax Number:
970-221-2727
Provider Enumeration Date:
03/28/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROWNE
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
970-221-0999

Provider Taxonomy Codes

  • Taxonomy code: 320800000X , with the licence number:  45178 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320800000X , with the licence number: 1616504 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 323P00000X , with the licence number: 45178 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 65572025 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 84988053 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".