NORTH RANGE BEHAVIORAL HEALTH (NPI# 1134454374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134454374 |
| Entity Type | Organization |
| Organization Name | NORTH RANGE BEHAVIORAL HEALTH |
| Practice Address |
1306 11th Ave Greeley CO 80631-9584 |
| Mailing Address |
1300 N 17th Ave Greeley CO 80631-3835 |
| Practice Telephone | 9703472120 |
| Mailing Telephone | 9703472120 |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2020-07-13 |
| NPI Deactivation Date | 06/12/2018 |
| NPI Reactivation Date | 2018-06-20 |
| Authorized Official Name | LARRY POTTORFF (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9703472373 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH RANGE BEHAVIORAL HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 16672054 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295060598 | North Range Behavioral Health | Clinic/Center | 1260 H St, Greeley, CO 80631-9115 | 2009-10-05 |
| 1275548638 | North Range Behavioral Health | Clinic/Center | 2350 W 3rd Street Rd, Greeley, CO 80631 | 2006-07-31 |
| 1669431524 | North Range Behavioral Health | Public Health or Welfare | 1300 N 17th Ave, Greeley, CO 80631 | 2006-03-20 |
| 1629684881 | North Range Behavioral Health | Clinic/Center | 1140 M St, Greeley, CO 80631-9586 | 2020-09-22 |
| 1386250843 | North Range Behavioral Health | Clinic/Center | 2930 11th Ave, Evans, CO 80620-1011 | 2020-09-21 |
| 1487260956 | North Range Behavioral Health | Clinic/Center | 1309 10th Ave, Greeley, CO 80631-3832 | 2020-09-21 |
| 1346856887 | North Range Behavioral Health | Clinic/Center | 1170 W Ash St Ste 100, Windsor, CO 80550-4783 | 2020-09-21 |
| 1215543855 | North Range Behavioral Health | Clinic/Center | 7251 W 20th St Unit C, Greeley, CO 80634-4626 | 2020-09-18 |
| 1598371494 | North Range Behavioral Health | Clinic/Center | 100 N 11th Ave, Greeley, CO 80631-2011 | 2020-09-17 |
| 1578179487 | North Range Behavioral Health | Clinic/Center | 928 12th St, Greeley, CO 80631-4024 | 2020-09-17 |
| Street Address |
1306 11TH AVE |
| City | GREELEY |
| State | CO |
| Zip Code | 80631-9584 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255303665 | Connie Lee Oravitz | Social Worker | 1306 11th Ave, Greeley, CO 80631-3835 | 2006-02-02 |
| 1467068379 | North Range Behavioral Health | Clinic/Center | 1306 11th Ave, Greeley, CO 80631-3835 | 2020-09-17 |
| 1851855274 | Mary Jane Peterson | Peer Specialist | 1306 11th Ave, Greeley, CO 80631-3835 | 2019-01-30 |
| 1326541269 | Paris Mcmanus | Case Manager/Care Coordinator | 1306 11th Ave, Greeley, CO 80631-3835 | 2018-03-16 |
| 1174053045 | Jessica Pratt | Counselor | 1306 11th Ave, Greeley, CO 80631-3835 | 2017-06-14 |
| 1801340203 | Edythe Peterson | Psychologist | 1306 11th Ave, Greeley, CO 80631-3835 | 2016-08-15 |
| 1992152425 | Danielle L Baker | Community Health Worker | 1306 11th Ave, Greeley, CO 80631-3835 | 2016-05-13 |
| 1093171779 | Ashley E Onderlinde | Community Health Worker | 1306 11th Ave, Greeley, CO 80631-3835 | 2016-01-11 |
| 1710351663 | Eric C Logan | Community Health Worker | 1306 11th Ave, Greeley, CO 80631-3835 | 2015-11-16 |
| 1023481181 | Cathy D Kellogg | Behavioral Analyst | 1306 11th Ave, Greeley, CO 80631-3835 | 2015-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497395743 | Marcia Martinez | Peer Specialist | 1700 N 17th Ave, Greeley, CO 80631 | 2020-01-14 |
| 1073083036 | Ryan Lawhead | Specialist/Technologist | 270 Alles Dr. D, Butler Hancock Athletic Center, Greeley, CO 80631 | 2018-12-03 |
| 1447766647 | Patricia G Ferguson | Counselor | 14272 Wcr 72, Greeley, CO 80631 | 2017-12-26 |
| 1760902662 | Robert Anthony Rexroad | Counselor | 1300 N. 17th Avenue, Greeley, CO 80631 | 2017-06-21 |
| 1326577750 | Danielle Rodriguez | Psychologist | 1300 N. 17th Ave, Greeley, CO 80631 | 2017-06-08 |
| 1790157865 | Safeway | Pharmacy | 3526 W 10th Street, Greeley, CO 80631 | 2015-10-28 |
| 1245574508 | Jayme L Clapp | Counselor | 1407 8th Ave, Greeley, CO 80631 | 2012-11-26 |
| 1114246006 | Cynthia Melissa Gitler | Emergency Medicine | Banner Health, North Colorado Medical Center, 1601 18th Street, Greenley, CO 80631 | 2010-05-18 |
| 1942438023 | Khoi Dinh Le | Surgery | 1800 15th St., Suite 200, Greeley, CO 80631 | 2009-06-26 |
| 1174760011 | Darwin James Hargrave | Counselor | 912 9th Ave., #222, Greeley, CO 80631 | 2009-01-14 |
| Find all providers in zip 80631 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295060598 | North Range Behavioral Health | Clinic/Center | 1260 H St, Greeley, CO 80631-9115 | 2009-10-05 |
| 1275548638 | North Range Behavioral Health | Clinic/Center | 2350 W 3rd Street Rd, Greeley, CO 80631 | 2006-07-31 |
| 1588289730 | Integrated Therapeutic Services, LLC | Clinic/Center | 1015 37th Avenue Ct Unit 102, Greeley, CO 80634-2500 | 2020-06-13 |
| 1427691831 | North Range Behavioral Health | Clinic/Center | 1407 8th Ave, Greeley, CO 80631-4603 | 2019-10-18 |
| 1184107088 | North Range Behavioral Health | Clinic/Center | 7251 W 20th St Unit C, Greeley, CO 80634-4626 | 2018-09-07 |
| 1598157653 | North Range Behavioral Health | Clinic/Center | 928 12th St, Greeley, CO 80631 | 2015-02-26 |
| 1033444278 | North Range Behavioral Health | Clinic/Center | 1140 M St, Greeley, CO 80631 | 2009-10-06 |
| 1457686693 | North Range Behavioral Health | Clinic/Center | 1309 10th Ave, Greeley, CO 80631 | 2009-10-06 |
| 1790010940 | North Range Behavioral Health | Clinic/Center | 100 N 11th Ave, Greeley, CO 80631 | 2009-10-06 |
| 1326371337 | Banner Greeley Specialists | Clinic/Center | 1800 15th St, Ste 200, Greeley, CO 80631-4500 | 2009-09-09 |
| Find all providers in GREELEY | ||||
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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.