Healthcare Provider Details

I. General information

NPI: 1154084689
Provider Name (Legal Business Name): LG BEHAVIORAL HEALTH OF COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 E BELLEVIEW AVE STE 300
GREENWOOD VILLAGE CO
80111-1629
US

IV. Provider business mailing address

6950 E BELLEVIEW AVE STE 300
GREENWOOD VILLAGE CO
80111-1629
US

V. Phone/Fax

Practice location:
  • Phone: 303-468-8018
  • Fax: 720-881-9063
Mailing address:
  • Phone: 303-468-8018
  • Fax: 720-881-9063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN LANIGAN
Title or Position: PARTNER
Credential:
Phone: 443-506-2513