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
1316 11TH AVE, GREELEY, CO 80631-3835
(970) 347-2120
Mailing address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2303FH
CDHPE
CO
Enumeration date
01/02/2019
Last updated
11/23/2020
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