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NPI Code Detail

MEDICARE: SEVEN DIMENSIONS BEHAVIORAL HEALTH, LLC

MEDICARE: SEVEN DIMENSIONS BEHAVIORAL HEALTH, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-14-15258CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114464187
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEVEN DIMENSIONS BEHAVIORAL HEALTH, LLC
Provider Business Mailing Address
First Line : 1035 EL RANCHO RD
Second Line :
City : EVERGREEN
State : CO
Zip : 80439-8238
Country : US
Telephone Number : 720-295-3790
Fax Number : 877-400-4480
Provider Business Practice Location Address
First Line : 1035 EL RANCHO RD
Second Line :
City : EVERGREEN
State : CO
Zip : 80439-8238
Country : US
Telephone Number : 720-295-3790
Fax Number : 877-400-4480
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : REBECCA ELIZABETH URBANO POWELL
Credential : BCBA
Telephone Number : 720-295-3790
Provider Enumeration Date : 01/27/2017
Last Update Date : 12/08/2022

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Practice Location Address:
1035 EL RANCHO RD
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80439-8238
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Practice Fax:
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EVERGREEN, CO
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1659847606 — MEAGHAN ELISABETH VAN KEUREN BCBA
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EVERGREEN, CO
80439-8238
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EVERGREEN, CO
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Practice Location Address:
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80439-8238
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