Organization
UPSON HALL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILBERT YATES (CONTRACT MANAGER)
(877) 262-7803
Entity
Organization
Contact information
Practice address
4411 E KENTUCKY AVE, GLENDALE, CO 80246-2009
(657) 304-0103
Mailing address
295 INTERLOCKEN BLVD STE 400, BROOMFIELD, CO 80021-8105
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
283Q00000X
Psychiatric Hospital
—
—
Other
Enumeration date
02/25/2022
Last updated
05/07/2025
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