MEDICARE: ALLIANCE MENTAL HEALTH - COLORADO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician
2	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770247702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE MENTAL HEALTH - COLORADO LLC

Provider Business Mailing Address
First Line	:	PO BOX 12192
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80212-0192
Country	:	US
Telephone Number	:	303-928-1051
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 S LEMAY AVE UNIT 3
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2247
Country	:	US
Telephone Number	:	303-928-1051
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RON LOBATO
Credential	:
Telephone Number	:	303-928-1051

Provider Enumeration Date	:	10/26/2021
Last Update Date	:	06/17/2025

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