Provider Demographics
NPI:1104447978
Name:NORTHERN COLORADO LIVING SOLUTIONS
Entity type:Organization
Organization Name:NORTHERN COLORADO LIVING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEURER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:970-388-5588
Mailing Address - Street 1:4021 SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1059
Mailing Address - Country:US
Mailing Address - Phone:970-388-5588
Mailing Address - Fax:970-449-4476
Practice Address - Street 1:4021 SPRUCE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1059
Practice Address - Country:US
Practice Address - Phone:970-388-5588
Practice Address - Fax:970-449-4476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-02
Last Update Date:2020-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1316928542Medicaid