Organization
GRAND VALLEY BEHAVIOR SERVICES AND CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN PHILLIPS (PRACTICE MANAGER)
(970) 317-7175
Entity
Organization
Contact information
Practice address
1025 MAIN ST, GRAND JUNCTION, CO 81501-3540
(970) 317-1715
(970) 360-5542
Mailing address
PO BOX 2924, GRAND JUNCTION, CO 81502-2924
(970) 317-7175
(970) 360-5542
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14564260
CAQH ID
—
05
—
9000176002
—
CO
05
—
9000188631
—
CO
Enumeration date
10/28/2020
Last updated
04/23/2021
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