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NPI Code Detail

MEDICARE: CONVERGE DAY TREATMENT CENTER

MEDICARE: CONVERGE DAY TREATMENT CENTER
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
1251S00000XCommunity/Behavioral Health Agency1654182CO

General Provider Information

NPI Number : 1245639491
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONVERGE DAY TREATMENT CENTER
Provider Business Mailing Address
First Line : 324 E RAILROAD AVE
Second Line : SUITE 500
City : FORT MORGAN
State : CO
Zip : 80701-3145
Country : US
Telephone Number : 970-867-0998
Fax Number : 970-367-1924
Provider Business Practice Location Address
First Line : 324 E RAILROAD AVE
Second Line : SUITE 500
City : FORT MORGAN
State : CO
Zip : 80701-3145
Country : US
Telephone Number : 970-867-0998
Fax Number : 970-367-1924
Authorized Official
Title or Position : DIRECTOR/LICENSED PSYCHOLOGIST
Name : DR. MONICA P BUETTEL
Credential : PH.D.
Telephone Number : 970-867-0998
Provider Enumeration Date : 08/13/2014
Last Update Date : 08/13/2014

Similar Medicare Providers

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Directions to “CONVERGE DAY TREATMENT CENTER ” Practice Location

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