NPIMap

Organization Active NPI

Island Grove Regional TRT Center

  • Substance Abuse Rehabilitation Facility
  • Greeley, CO
National Provider Identifier
1386782142
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
ISLAND GROVE REGIONAL TRT CENTER
Practice address
1140 M Street
Greeley, CO 80631
Phone
(970) 356-6664
Fax
(970) 356-1349
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Kendall P Alexander, LCSW
Title
Executive Director
Phone
(970) 313-1186

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X CO Primary

Addresses

Primary practice location

1140 M Street
Greeley, CO 80631

Mailing address

1140 M Street
Greeley, CO 80631
Phone (970) 356-6664

National Provider Directory

National Provider Directory
Tax ID family
Island Grove Regional Treatment Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386782142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 M STREET",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80631",
            "telephone_number": "970-356-6664",
            "fax_number": "970-356-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 M STREET",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80631",
            "telephone_number": "970-356-6664",
            "fax_number": "970-356-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND GROVE REGIONAL TRT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "970-313-1186",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.