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Organization

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Organization subpart
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Provider details

NPI number
Authorized official
ANGELA HART (EXECUTIVE DIRECTOR)
(970) 988-1856
Entity
Organization

Contact information

Practice address
111 E CHARLOTTE ST, JOHNSTOWN, CO 80534-7809
(970) 988-1856
Mailing address
446 GRANGE LN, JOHNSTOWN, CO 80534-7827
(970) 988-1856

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
10/06/2025
Last updated
10/06/2025
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