Provider Demographics
NPI:1861082596
Name:INTERIM HEALTHCARE OF FORT COLLINS, INC.
Entity type:Organization
Organization Name:INTERIM HEALTHCARE OF FORT COLLINS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:RINGLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-632-9900
Mailing Address - Street 1:2000 VERMONT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2900
Mailing Address - Country:US
Mailing Address - Phone:970-472-4181
Mailing Address - Fax:970-472-4183
Practice Address - Street 1:2000 VERMONT DR STE 100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2900
Practice Address - Country:US
Practice Address - Phone:970-472-4181
Practice Address - Fax:970-472-4183
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE OF FORT COLLINS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85431290Medicaid