MEDICARE: FIDELITY 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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1679330757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIDELITY BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	8510 BRYANT ST STE 330
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-3845
Country	:	US
Telephone Number	:	949-793-1486
Fax Number	:	720-783-4756

Provider Business Practice Location Address
First Line	:	8510 BRYANT ST STE 330
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80031-3845
Country	:	US
Telephone Number	:	720-955-9887
Fax Number	:	720-783-4756

Authorized Official
Title or Position	:	COO
Name	:	MORGAN PATRICK MATHEWS
Credential	:
Telephone Number	:	949-793-1486

Provider Enumeration Date	:	03/05/2024
Last Update Date	:	05/25/2026

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