Provider Demographics
NPI:1538734462
Name:NORTHERN TWILIGHT INC
Entity type:Organization
Organization Name:NORTHERN TWILIGHT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-273-5649
Mailing Address - Street 1:4251 KIPLING ST UNIT 535
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6836
Mailing Address - Country:US
Mailing Address - Phone:303-232-9999
Mailing Address - Fax:
Practice Address - Street 1:4251 KIPLING ST UNIT 535
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6836
Practice Address - Country:US
Practice Address - Phone:303-232-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care