NPIMap

Centennial Mental Health Center, Inc.

Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Fort Morgan, CO

NPI 1548865017 · NPPES record last updated Jul 15, 2021

Key facts

NPI
1548865017
Entity type
Organization (NPI type 2)
Primary specialty
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Legal business name
CENTENNIAL MENTAL HEALTH CENTER, INC.
Practice address
230 W Kiowa Ave
Fort Morgan, CO 80701-2368
Phone
(970) 466-0639
NPI assigned
Dec 2, 2020
Organization subpart
No

Authorized official

Name
Sherri Davidson
Title
Finance Director
Phone
(970) 522-4549

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Centennial Mental Healt (65 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

230 W Kiowa Ave
Fort Morgan, CO 80701-2368

Mailing address

211 W Main St
Sterling, CO 80751-3168
Phone (970) 522-4549

Other identifiers

IdentifierTypeStateIssuer
04110094MedicaidCO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 15, 2021.

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1548865017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W MAIN ST",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "807513168",
            "telephone_number": "970-522-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W KIOWA AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807012368",
            "telephone_number": "970-466-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "970-522-4549"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04110094",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Morgan, CO

All providers in Fort Morgan, CO · Substance Use Disorder Rehabilitation Clinic/Center in Colorado

Sources for this page

Verify at the official NPI Registry.