Organization
CLINICA CAMPESINA FAMILY HEALTH SERVICES
Active
Other names
Mental Health Partners, Clinica Family Health and Wellness, Mental Health Center of Boulder County, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN J JOHNSTON (CFO)
(303) 926-0625
Entity
Organization
Contact information
Practice address
975 NORTH ST, BOULDER, CO 80304-3279
(303) 443-8500
(720) 687-2752
Mailing address
1455 DIXON AVE, LAFAYETTE, CO 80026-8879
(303) 443-8500
(720) 687-2752
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43105106
—
CO
Enumeration date
07/09/2024
Last updated
12/17/2024
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