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
1306 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
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000164585
—
CO
Enumeration date
09/17/2020
Last updated
09/17/2020
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