Healthcare Provider Details

I. General information

NPI: 1629683404
Provider Name (Legal Business Name): COMMUNITY REACH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 E EGBERT ST STE 200
BRIGHTON CO
80601-2484
US

IV. Provider business mailing address

1870 W 122ND AVE STE 100
WESTMINSTER CO
80234-2075
US

V. Phone/Fax

Practice location:
  • Phone: 303-853-3500
  • Fax:
Mailing address:
  • Phone: 303-853-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RYSHELL SCHRADER
Title or Position: BILLING AND CODING MANAGER
Credential:
Phone: 303-412-6091