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Organization

BANYAN CASTLE ROCK, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANASTASIA NICHOLE NAUMAN (CONTRACTING & CREDENTIALING MANAGER)
(954) 533-7705
Entity
Organization

Contact information

Practice address
1055 S PERRY ST, CASTLE ROCK, CO 80104-1949
(303) 381-8340
(303) 381-8341
Mailing address
225 N FEDERAL HWY, POMPANO BEACH, FL 33062-4319
(954) 533-7705
(954) 781-7173

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
09/15/2025
Last updated
09/15/2025
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