Centennial Mental Health Center, Inc.
Organization Active NPI Community/Behavioral Health Agency · Cheyenne Wells, CO
NPI 1003673526 · NPPES record last updated Mar 1, 2024
Key facts
- NPI
- 1003673526
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- CENTENNIAL MENTAL HEALTH CENTER, INC.
- Practice address
- 80 E 1St St N
Cheyenne Wells, CO 80810-5008 - Phone
- (719) 346-8183
- NPI assigned
- Mar 1, 2024
- Organization subpart
- No
Authorized official
- Name
- Sherri Davidson
- Title
- Chief Financial Officer
- Phone
- (970) 522-4549
Other NPIs on the same Medicare enrollment 11
Corporate family (same tax ID) 12
Practitioners 3
-
Cynthia Ann Audia, LPC
-
Shayla Skahill, LPC
-
Lily Moon, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040331000194 | CO | Part B Supplier - Clinic/Group Practice | 5193717213 |
Receives reassigned benefits from 26 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Elizabeth, CO; Yuma, CO; Wray, CO; Sterling, CO; Limon, CO; Julesburg, CO; Holyoke, CO; Fort Morgan, CO… |
National Provider Directory
- Tax ID family
- Centennial Mental Healt
Locations
211 W Main St
Sterling, CO 80751
Phone (970) 522-4392
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
80 E 1St St N
Cheyenne Wells, CO 80810-5008
Mailing address
211 W Main St
Sterling, CO 80751-3168
Phone (970) 522-4549
Other providers in Cheyenne Wells, CO
- Kelli Dawn Adamson
- Edward David Boudreau
- Centennial Mental Health Center, Inc.
- Centennial Mental Health Center, Inc.
- Centennial Mental Health Center, Inc.
- Centennial Mental Helath Center
- Cheyenne County Hospital District
All providers in Cheyenne Wells, CO · Community/Behavioral Health Agency in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.