NPIMap

Organization Active NPI

Centennial Mental Health Center, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Yuma, CO
National Provider Identifier
1578082053
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
1145-10 Issued in CO
Legal business name
CENTENNIAL MENTAL HEALTH CENTER, INC.
Practice address
215 S Ash St
Yuma, CO 80759-1903
Phone
(970) 848-5412
Fax
(970) 848-2414
NPI assigned
Sep 15, 2017
Last updated
Jul 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTENNIAL MENTAL HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Elizabeth L Hickman, PHDNPI 1437114428
Title
Executive Director
Phone
(970) 522-4549

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 1145-10 CO Primary

Addresses

Primary practice location

215 S Ash St
Yuma, CO 80759-1903

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Centennial Mental Healt65 organizations share this tax ID, including this one
Part of
Centennial Mental Healt

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1578082053",
    "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",
            "fax_number": "970-522-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S ASH ST",
            "city": "YUMA",
            "state": "CO",
            "postal_code": "807591903",
            "telephone_number": "970-848-5412",
            "fax_number": "970-848-2414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTENNIAL MENTAL HEALTH CENTER, INC.",
        "enumeration_date": "2017-09-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "970-522-4549",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CO",
            "license": "1145-10",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.