Basic Information
| Provider Information | |||||||||
| NPI: | 1962637181 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NCMC BEHAVIORAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 928 12TH ST | ||||||||
| Address2: | |||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806314024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703521056 | ||||||||
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| Practice Location | |||||||||
| Address1: | 928 12TH ST | ||||||||
| Address2: | |||||||||
| City: | GREELEY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 806314024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703521056 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2009 | ||||||||
| LastUpdateDate: | 05/18/2009 | ||||||||
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| AuthorizedOfficialLastName: | HESTER | ||||||||
| AuthorizedOfficialFirstName: | RENEE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OUTPATIENT MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9703364933 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | CO | Y | Hospital Units | Psychiatric Unit |
No ID Information.