Provider Demographics
NPI:1316815467
Name:A LIFE WORTH LIVING
Entity type:Organization
Organization Name:A LIFE WORTH LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETCAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-484-2023
Mailing Address - Street 1:1225 REDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2052
Mailing Address - Country:US
Mailing Address - Phone:970-484-2023
Mailing Address - Fax:866-867-8553
Practice Address - Street 1:1225 REDWOOD ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2052
Practice Address - Country:US
Practice Address - Phone:970-484-2023
Practice Address - Fax:866-867-8553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-29
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty