Basic Information
| Provider Information | |||||||||
| NPI: | 1225267883 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COLORADO PSYCHIATRY CENTER, PC | ||||||||
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| OtherOrganizationName: | COLORADO PSYCHIATRY CENTER | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11154 HURON STREET | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | NORTHGLENN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802342329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039205161 | ||||||||
| FaxNumber: | 3034524625 | ||||||||
| Practice Location | |||||||||
| Address1: | 11154 HURON STREET | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | NORTHGLENN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802342329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039205161 | ||||||||
| FaxNumber: | 3034524625 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2009 | ||||||||
| LastUpdateDate: | 03/31/2022 | ||||||||
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| AuthorizedOfficialLastName: | MORLEY | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3039205161 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D | ||||||||
| NPICertificationDate: | 03/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 261QM0855X | DR45008 | CO | Y | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No ID Information.