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General NPI Number Information
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NPI Number | 1164726261
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Entity Type | Organization
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Legal Business Name | GARFIELD DAY TREATMENT PORGRAM
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 520 S 3RD ST SUITE 24
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City | CARBONDALE
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State | CO
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Zip | 81623-2059
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Country | US
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Telephone | 970-963-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 1644 S COLLEGE AVE
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City | FORT COLLINS
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State | CO
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Zip | 80525-1007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | KIMBERLY BAPPE
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Credential | LCSW, LAC
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Telephone | 970-567-0938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1594820
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License Number State | CO
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