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Organization

NORTH RANGE BEHAVIORAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LARRY POTTORFF (EXECUTIVE DIRECTOR)
(970) 347-2373
Entity
Organization

Contact information

Practice address
1260 H ST, GREELEY, CO 80631-9115
(970) 347-2120
Mailing address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2110

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1386-05
DHS-OBH
CO
Enumeration date
07/16/2020
Last updated
07/16/2020
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