MEDICARE: GRAND JUNCTION REGIONAL 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
1	251C00000X	Developmentally Disabled Services Day Training Agency	0146	CO

Other Identifiers

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

General Provider Information

NPI Number	:	1760515241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAND JUNCTION REGIONAL CENTER

Provider Business Mailing Address
First Line	:	2800 D RD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-4721
Country	:	US
Telephone Number	:	970-245-2100
Fax Number	:	970-255-5714

Provider Business Practice Location Address
First Line	:	572 W CRETE CIR
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-6912
Country	:	US
Telephone Number	:	970-245-2100
Fax Number	:	970-255-5714

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. JENNIFER A BROWN
Credential	:	RN
Telephone Number	:	970-255-5703

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	05/15/2024

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