Organization
ADDICTION TREATMENT CENTER OF LONGMONT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT HENRY EISERMAN (EXECUTIVE DIRECTOR)
(303) 651-9282
Entity
Organization
Contact information
Practice address
2130 MOUNTAIN VIEW AVENUE, SUITE A-2, LONGMONT, CO 80501
(303) 651-9200
Mailing address
2130 MOUNTAIN VIEW AVENUE, A-2, LONGMONT, CO 80501
(303) 651-9200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1311-00
CO
Other
Enumeration date
10/02/2006
Last updated
08/22/2020
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