| |
1455 Dixon Ave Lafayette CO 80026-8879 | |
(303) 443-8500 | |
Not Available |
Full Name | |
---|---|
Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 1455 Dixon Ave, Lafayette, 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 |
---|---|
1455 Dixon Ave Ste 300 Lafayette CO 80026-8880 Ph: (303) 443-8500 | 1455 Dixon Ave Lafayette CO 80026-8879 Ph: (303) 443-8500 |
NPI Number | 1902494081 |
---|---|
Provider Enumeration Date | 01/05/2021 |
Last Update Date | 01/03/2025 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902494081 | NPI | - | NPPES |
9000230297 | Medicaid | CO |
Banner Greeley Specialists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Exempla Cir, Suite 200, Lafayette, CO 80026 Phone: 970-378-4433 | |