| Lighthouse Wholehealth Family Center | |
|
300 E Horsetooth Rd Ste 200 Fort Collins CO 80525-3154 | |
| (303) 929-6743 | |
| Not Available |
| Full Name | Lighthouse Wholehealth Family Center |
|---|---|
| Speciality | Specialist |
| Location | 300 E Horsetooth Rd Ste 200, Fort Collins, Colorado |
| Authorized Official Name and Position | Jennifer Bergin (OWNER) |
| Authorized Official Contact | 3039296743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Wholehealth Family Center 1785 Nighfall Drive Windsor CO 80550 Ph: (303) 929-6743 | Lighthouse Wholehealth Family Center 300 E Horsetooth Rd Ste 200 Fort Collins CO 80525-3154 Ph: (303) 929-6743 |
| NPI Number | 1982389003 |
|---|---|
| Provider Enumeration Date | 06/16/2023 |
| Last Update Date | 10/11/2023 |
| Certification Date | 10/11/2023 |
| Medicare PECOS PAC ID | 5193171262 |
|---|---|
| Medicare Enrollment ID | O20231025002337 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982389003 | NPI | - | NPPES |
| 9000218730 | Medicaid | CO |
| Provider Name | Kelly Lenn Yeldell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366676249 PECOS PAC ID: 9638585599 Enrollment ID: I20210302000357 |
| Provider Name | Jennifer N Bergin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376804740 PECOS PAC ID: 9638525702 Enrollment ID: I20240111004467 |
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