Organization
OPTUM BEHAVIORAL CARE OF COLORADO, P.C.
Active
Other names
Child & Family Psychological Services of Michigan
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE JOHNSON (CEO)
(704) 506-6267
Entity
Organization
Contact information
Practice address
1662 E CENTRE AVE, PORTAGE, MI 49002-4496
(269) 321-8564
Mailing address
11000 OPTUM CIR, EDEN PRAIRIE, MN 55344-2503
(269) 321-8564
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
03/24/2025
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