NPIMap

Organization Active NPI

Excelsior Youth Center

  • Mental Illness Community Based Residential Treatment Facility
  • Aurora, CO
National Provider Identifier
1104124148
Registry record updated Feb 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
45243 Issued in CO
Legal business name
EXCELSIOR YOUTH CENTER
Practice address
15001 E Oxford Ave
Aurora, CO 80014-4186
Phone
(303) 693-1550
Fax
(303) 693-8309
NPI assigned
Feb 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2011

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

Authorized official

Name
Joan Gabrielson
Title
Director
Phone
(303) 693-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 45243 CO Primary

Addresses

Primary practice location

15001 E Oxford Ave
Aurora, CO 80014-4186

Mailing address

15001 E Oxford Ave
Aurora, CO 80014-4186
Phone (303) 693-1550

Other identifiers 1

IdentifierTypeStateIssuer
53239873MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Excelsior Youth Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298851200000",
    "number": "1104124148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15001 E OXFORD AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800144186",
            "telephone_number": "303-693-1550",
            "fax_number": "303-693-8309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15001 E OXFORD AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800144186",
            "telephone_number": "303-693-1550",
            "fax_number": "303-693-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR YOUTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-28",
        "last_updated": "2011-02-28",
        "status": "A",
        "authorized_official_last_name": "GABRIELSON",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "303-693-1550"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "CO",
            "license": "45243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53239873",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; 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.