Healthcare Provider Details

I. General information

NPI: 1679298798
Provider Name (Legal Business Name): PLEASANT VALLEY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 LINCOLN AVE STE 200
STEAMBOAT SPRINGS CO
80487-4972
US

IV. Provider business mailing address

29220 RCR 14B
STEAMBOAT SPRINGS CO
80487-9613
US

V. Phone/Fax

Practice location:
  • Phone: 970-478-1181
  • Fax: 970-585-7691
Mailing address:
  • Phone: 970-367-6396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JANELLE KAY HOAGLUND
Title or Position: CEO
Credential: PMHNP
Phone: 970-367-6396