Healthcare Provider Details

I. General information

NPI: 1164055075
Provider Name (Legal Business Name): COLORADO WEST REGIONAL MENTAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 WAPITI CT UNIT 202B
RIFLE CO
81650-3444
US

IV. Provider business mailing address

PO BOX 3807
GRAND JUNCTION CO
81502-3807
US

V. Phone/Fax

Practice location:
  • Phone: 970-625-3582
  • Fax:
Mailing address:
  • Phone: 970-241-6023
  • Fax: 970-243-8631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HARMONY MICHELE FRENCH
Title or Position: MANAGER OF REVENUE CYCLE
Credential:
Phone: 970-683-7083