EXCELSIOR YOUTH CENTER (NPI# 1104124148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104124148 |
| Entity Type | Organization |
| Organization Name | EXCELSIOR YOUTH CENTER |
| Practice Address |
15001 E Oxford Ave Aurora CO 80014-4186 |
| Practice Telephone | 3036931550 |
| Practice Fax Number | 3036938309 |
| Mailing Telephone | 3036931550 |
| Mailing Fax Number | 3036938309 |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-02-28 |
| Authorized Official Name | JOAN GABRIELSON (DIRECTOR) |
| Authorized Official Telephone | 3036931550 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 45243 | CO | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 53239873 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982995288 | Excelsior Youth Center | Public Health or Welfare | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2011-04-21 |
| 1326267055 | Excelsior Youth Center | Clinic/Center | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2007-04-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EXCELSIOR YOUTH CENTER | 3754 W Indian Trail Rd, Spokane, WA 99208 |
| Street Address |
15001 E OXFORD AVE |
| City | AURORA |
| State | CO |
| Zip Code | 80014-4186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407873342 | Excelsior Youth Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2006-07-16 |
| 1518401967 | Chanelle N Pugh | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4191 | 2016-12-05 |
| 1679025951 | Rudy Balquin | Community Based Residential Treatment Facility, Mental Illness | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-11-02 |
| 1861946147 | Lisa Post | Residential Treatment Facility, Emotionally Disturbed Children | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-08-04 |
| 1790238152 | Serena Marie Marez Norell | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-08-02 |
| 1508319906 | Yesenia Arredondo | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-08-02 |
| 1669820593 | Cydney Horton | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-06-01 |
| 1437510906 | Nicole Termeer | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-03-11 |
| 1528428687 | Katie Lockley | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-03-02 |
| 1720448152 | Emily Dombrowski | Counselor | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942825021 | Dieuvil Varice | Occupational Therapist | 2851 S Parker Rd Ste 570, Aurora, Co, Aurora, CO 80014 | 2020-06-14 |
| 1518437144 | Curtis E Redd | Case Manager/Care Coordinator | 1059 E Bethany Dr, Suite 200, Aurora, CO 80014 | 2018-11-27 |
| 1144795154 | Prestige Adult Day Care LLC | Clinic/Center | 2860 S Havana St, Unit C, Aurora, CO 80014 | 2018-10-05 |
| 1609375492 | Jacob Mcbride | Behavior Technician | 2121 S Blackhawk St 100, Aurora, CO 80014 | 2018-02-07 |
| 1265931240 | Jasmine Nicole Joseph | Behavior Technician | 2121 S. Blackhawk St., Aurora, CO 80014 | 2018-02-06 |
| 1255830238 | Russel Talukder | Behavioral Analyst | 2121 South Blackhawk St 100, Aurora, CO 80014 | 2018-02-06 |
| 1467951442 | Dylan Kelley | Behavior Technician | 2121 Blackhawk St. Suite 100, Aurora, CO 80014 | 2018-02-06 |
| 1184123168 | Talisa Fisher | Behavior Technician | 2121 S Blackhawk St Suite 100, Aurora, CO 80014 | 2018-02-06 |
| 1144732314 | Hellen A Noamesi | Registered Nurse | Kaiser Water Park 1, 2500 S. Havana St, Aurora, CO 80014 | 2017-10-27 |
| 1255840641 | Amanda Dawn Thompson | Massage Therapist | 3035 South Parker Rd., 560 Building E, Aurora, CO 80014 | 2017-09-28 |
| Find all providers in zip 80014 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417191693 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 123 Salt Lake St, Aurora, IL 60506 | 2009-05-01 |
| 1093312837 | Aurora Comprehensive Community Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 16390 E 14th Pl, Aurora, CO 80011-7411 | 2020-10-05 |
| 1437756624 | Aurora Comprehensive Community Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 51 Lima St, Aurora, CO 80010-4616 | 2020-10-01 |
| 1811435035 | Centoria Thompson | Community Based Residential Treatment Facility, Mental Illness | 11059 E Bethany Dr, Aurora, CO 80014-2622 | 2017-02-08 |
| 1679025951 | Rudy Balquin | Community Based Residential Treatment Facility, Mental Illness | 15001 E Oxford Ave, Aurora, CO 80014-4186 | 2016-11-02 |
| 1790113132 | Rasheta Butler | Community Based Residential Treatment Facility, Mental Illness | 1230 Pearl St, Aurora, IL 60505-4519 | 2013-10-22 |
| 1679900690 | The Association for Individual Development | Community Based Residential Treatment Facility, Mental Illness | 1230 Pearl St, Aurora, IL 60505-4519 | 2013-10-04 |
| 1275896037 | Maxim | Community Based Residential Treatment Facility, Mental Illness | 17908 E Amherst Ave, Aurora, CO 80013-2122 | 2012-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134632896 | Aspinwall Limited Liability Company | Community Based Residential Treatment Facility, Mental Illness | 8263 E Mansfield Ave, Denver, CO 80237-1722 | 2017-11-15 |
| 1972038313 | Girls Only Ministry | Community Based Residential Treatment Facility, Mental Illness | 655 North 16th Way, Brighton, CO 80601 | 2017-04-24 |
| 1730611146 | Rite of Passage, Inc | Community Based Residential Treatment Facility, Mental Illness | 5924 Us Highway 285, Morrison, CO 80465-9101 | 2017-04-03 |
| 1720538648 | Maddisen Mosser | Community Based Residential Treatment Facility, Mental Illness | 8400 E Yale Ave Apt 2-208, Denver, CO 80231-3853 | 2016-10-04 |
| 1124497268 | Daniel Little | Community Based Residential Treatment Facility, Mental Illness | 3764 Silverton Street, Boulder, CO 80301 | 2015-09-18 |
| 1740699362 | Turning Point Center for Youth and Family Development, Inc. | Community Based Residential Treatment Facility, Mental Illness | 640 W Prospect Rd, Fort Collins, CO 80526-1918 | 2014-08-07 |
| 1699184416 | Turning Point Center for Youth and Family Development, Inc. | Community Based Residential Treatment Facility, Mental Illness | 10431 N County Road 15, Fort Collins, CO 80524-8733 | 2014-08-06 |
| 1528470036 | Steps2hope | Community Based Residential Treatment Facility, Mental Illness | 3261 Raleigh St, Denver, CO 80212-1707 | 2014-06-02 |
| 1447692876 | La Mar Child Placemnt Agency | Community Based Residential Treatment Facility, Mental Illness | 5315 Hicks Dr, Colorado Springs, CO 80911-3615 | 2013-07-26 |
| 1316280365 | Urban Peak | Community Based Residential Treatment Facility, Mental Illness | 1630 S Acoma St, Denver, CO 80223-3602 | 2013-03-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.