Organization
MIDWAY YOUTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBRA RACHELLE MONTOYA MA, LPC (CLINICAL DIRECTOR)
(970) 484-7447
Entity
Organization
Contact information
Practice address
1516 REMINGTON ST, FORT COLLINS, CO 80524-4140
(970) 484-7447
(970) 484-7471
Mailing address
729 REMINGTON ST, FORT COLLINS, CO 80524-3332
(970) 484-7447
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
44002
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67458297
—
CO
Enumeration date
03/12/2007
Last updated
08/22/2020
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