Provider Demographics
NPI:1548451339
Name:LARIMER COUNTY
Entity type:Organization
Organization Name:LARIMER COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-498-7488
Mailing Address - Street 1:2255 MIDPOINT DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4306
Mailing Address - Country:US
Mailing Address - Phone:970-498-7530
Mailing Address - Fax:970-498-7532
Practice Address - Street 1:2255 MIDPOINT DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4306
Practice Address - Country:US
Practice Address - Phone:970-498-7530
Practice Address - Fax:970-498-7532
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LARIMER COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-06
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1558-1251S00000X, 324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health