Provider Demographics
NPI:1871322404
Name:NORTHPOINT COLORADO LLC
Entity type:Organization
Organization Name:NORTHPOINT COLORADO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-605-7070
Mailing Address - Street 1:3515 E OVERLAND RD
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-6757
Mailing Address - Country:US
Mailing Address - Phone:208-605-7070
Mailing Address - Fax:
Practice Address - Street 1:3800 AUTOMATION WAY STE 102
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3451
Practice Address - Country:US
Practice Address - Phone:970-900-5835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHPOINT COLORADO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty