Healthcare Provider Details
I. General information
NPI: 1043856933
Provider Name (Legal Business Name): ARRAY CLINICAL AND THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/26/2019
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1349 CLEVELAND AVE
LOVELAND CO
80537-4726
US
IV. Provider business mailing address
1349 CLEVELAND AVE
LOVELAND CO
80537-4726
US
V. Phone/Fax
- Phone: 800-440-1652
- Fax: 970-775-8107
- Phone: 800-440-1652
- Fax: 303-545-5296
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
KELLY ORDWAY
Title or Position: CDO
Credential:
Phone: 954-557-0474