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General NPI Number Information
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NPI Number | 1073165296
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Entity Type | Organization
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Legal Business Name | NORTHERN HORIZON BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 109 N RUTHERFORD AVE
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City | JOHNSTOWN
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State | CO
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Zip | 80534-8639
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Country | US
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Telephone | 970-619-1920
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Fax | 970-449-7519
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Provider Business Mailing Address
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Address Line | 138 E 4TH ST STE 8
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City | LOVELAND
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State | CO
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Zip | 80537-5502
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Country | US
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Telephone | 970-619-1920
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BROOKE JOHNSON
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Credential |
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Telephone | 970-534-1967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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