NPIMap

Organization Active NPI

Southeast Mental Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ordway, CO
National Provider Identifier
1073118394
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SOUTHEAST MENTAL HEALTH SERVICES
Practice address
220 E 1St St
Ordway, CO 81063-1433
Phone
(719) 384-5446
NPI assigned
Dec 3, 2020
Last updated
Dec 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carol A Aragon
Title
Credentialing Specialist
Phone
(719) 383-5408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

220 E 1St St
Ordway, CO 81063-1433

Mailing address

711 Barnes Ave
La Junta, CO 81050-2138

Other identifiers 1

IdentifierTypeStateIssuer
08880051MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Southeast Mental Health Services23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

220 E 1st St
Ordway, CO 81063

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1073118394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 BARNES AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810502138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E 1ST ST",
            "city": "ORDWAY",
            "state": "CO",
            "postal_code": "810631433",
            "telephone_number": "719-384-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "ARAGON",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "719-383-5408"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08880051",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ordway, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.