| North Range Behavioral Health | |
|
145 1st St Fort Lupton CO 80621-2002 | |
| (303) 857-6365 | |
| Not Available |
| Full Name | North Range Behavioral Health |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 145 1st St, Fort Lupton, Colorado |
| Authorized Official Name and Position | Larry Pottorff (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9703472373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Range Behavioral Health 1300 N 17th Ave Greely CO 80631-9584 Ph: (970) 347-2120 | North Range Behavioral Health 145 1st St Fort Lupton CO 80621-2002 Ph: (303) 857-6365 |
| NPI Number | 1346575586 |
|---|---|
| Provider Enumeration Date | 10/06/2009 |
| Last Update Date | 11/23/2020 |
| Certification Date | 11/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346575586 | NPI | - | NPPES |
| 12837377 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Buffalo Run Group Home, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14459 County Road 18 1/2, Fort Lupton, CO 80621 Phone: 303-318-0311 Fax: 303-318-0288 |