Healthcare Provider Details

I. General information

NPI: 1255012936
Provider Name (Legal Business Name): COLORADO WEST REGIONAL MENTAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 BREEZE ST
CRAIG CO
81625-2650
US

IV. Provider business mailing address

PO BOX 3807
GRAND JUNCTION CO
81502-3807
US

V. Phone/Fax

Practice location:
  • Phone: 970-824-6541
  • Fax:
Mailing address:
  • Phone: 970-241-6023
  • Fax: 970-243-8631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier4998084
Identifier TypeMEDICAID
Identifier StateCO
Identifier Issuer

VIII. Authorized Official

Name: JASON CHIPPEAUX
Title or Position: PRESIDENT/CEO
Credential:
Phone: 719-545-2746