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
2930 11TH AVE, EVANS, CO 80620
(970) 347-2120
Mailing address
1300 N 17TH AVE, GREELY, CO 80631-9584
(970) 347-2120
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50655248
—
CO
Enumeration date
10/06/2009
Last updated
11/23/2020
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