| Organization Name: | PORTER ADVENTIST HOSPITAL |
| NPI Number: | 1013178557 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEIDI A BODE (PSYCHOTHERAPIST) |
| Mailing Address: | 851 Sleepy Hollow Dr Bailey |
| State: | CO US |
| Postal Code: | 804212068 |
| Phone Number: | 3032296692 |
| Fax Number: | |
| NPI Enumeration Date: | 06/18/2008 |
| NPI Last Update Date: | 02/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | 9706 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |