# ADDICTION TREATMENT CENTER OF LONGMONT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508950007
- **Authorized official:** MR. ROBERT HENRY EISERMAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (303) 651-9282

## Contact information

- **Practice address:** 2130 MOUNTAIN VIEW AVENUE, SUITE A-2, LONGMONT, CO 80501
- **Practice address phone:** (303) 651-9200
- **Mailing address:** 2130 MOUNTAIN VIEW AVENUE, A-2, LONGMONT, CO 80501
- **Mailing address phone:** (303) 651-9200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 1311-00 | CO | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 08/22/2020