Healthcare Provider Details
I. General information
NPI: 1255995783
Provider Name (Legal Business Name): COLORADO WEST REGIONAL MENTAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2019
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
439 BREEZE ST STE 200
CRAIG CO
81625-2646
US
IV. Provider business mailing address
715 HORIZON DR STE 225
GRAND JUNCTION CO
81506-8743
US
V. Phone/Fax
- Phone: 970-241-6023
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
NATALIE
LYNN
ODUEKE
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 970-683-2083