Healthcare Provider Details

I. General information

NPI: 1154254076
Provider Name (Legal Business Name): NORTH RANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

928 12TH ST
GREELEY CO
80631-4024
US

IV. Provider business mailing address

1300 N 17TH AVE # 80631
GREELEY CO
80631-9584
US

V. Phone/Fax

Practice location:
  • Phone: 970-347-2120
  • Fax:
Mailing address:
  • Phone: 970-347-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SABRE BIRDSELL
Title or Position: CO RESPONDER
Credential:
Phone: 720-338-6045