| |
834 S Sherman St Longmont CO 80501-6323 | |
(303) 443-8500 | |
(720) 687-2752 |
Full Name | |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 834 S Sherman St, Longmont, Colorado |
Authorized Official Name and Position | Brian J Johnston (CFO) |
Authorized Official Contact | 3039260625 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1455 Dixon Ave Lafayette CO 80026-8879 Ph: (303) 443-8500 | 834 S Sherman St Longmont CO 80501-6323 Ph: (303) 443-8500 |
NPI Number | 1558109223 |
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Provider Enumeration Date | 07/17/2024 |
Last Update Date | 12/17/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558109223 | NPI | - | NPPES |
43685030 | Medicaid | CO |
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