Healthcare Provider Details

I. General information

NPI: 1972432623
Provider Name (Legal Business Name): JAMES L BAKEHOUSE CAT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2956 NORTH AVE STE 1
GRAND JUNCTION CO
81504-3919
US

IV. Provider business mailing address

2956 NORTH AVE STE 1
GRAND JUNCTION CO
81504-3919
US

V. Phone/Fax

Practice location:
  • Phone: 970-208-1130
  • Fax: 970-208-1132
Mailing address:
  • Phone: 970-208-1130
  • Fax: 970-208-1132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACA.0008202
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: