Organization
ISLAND GROVE REGIONAL TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENDALL P ALEXANDER MSW (EXECUTIVE DIRECTOR)
(970) 356-6664
Entity
Organization
Contact information
Practice address
1260 H STREET, GREELEY, CO 80631
(970) 351-6678
(970) 352-7457
Mailing address
1260 H STREET, GREELEY, CO 80631
(970) 351-6678
(970) 352-7457
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
105109
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04055764
—
CO
Enumeration date
02/07/2008
Last updated
02/07/2008
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