Healthcare Provider Details

I. General information

NPI: 1558915090
Provider Name (Legal Business Name): ARRAY CLINICAL AND THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 21ST AVE. SUITE B
LONGMONT CO
80501
US

IV. Provider business mailing address

451 21ST AVE. SUITE B
LONGMONT CO
80501
US

V. Phone/Fax

Practice location:
  • Phone: 800-440-1652
  • Fax: 970-775-8107
Mailing address:
  • Phone: 303-545-5296
  • Fax: 303-545-5296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER KELLY ORDWAY
Title or Position: CHIEF DEVELOPMENT OFFICER
Credential:
Phone: 303-824-9350