Centennial Mental Health Center, Inc.
Organization Active NPI Community/Behavioral Health Agency · Julesburg, CO
NPI 1710744693 · NPPES record last updated Mar 6, 2024
Key facts
- NPI
- 1710744693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- CENTENNIAL MENTAL HEALTH CENTER, INC.
- Practice address
- 118 W 3Rd St
Julesburg, CO 80737-1542 - Phone
- (970) 474-3769
- NPI assigned
- Mar 6, 2024
- Organization subpart
- No
Authorized official
- Name
- Sherri Davidson
- Title
- Cfo
- Phone
- (970) 522-4549
Other NPIs on the same Medicare enrollment 11
Corporate family (same tax ID) 24
Practitioners 20
-
Cynthia Ann Audia, LPC
-
Jackie Barton, LCSW
-
Leah Elizabeth Brown, NP-C
-
Regina Ann Dardanes, MA, LPC
-
Briana Gauvin, MSW
-
Ramon Martinez, NURSE PRACTITIONER
-
Harold McNerney, MSW, LCSW
-
Laine Marie Morgan, PMHNP,RXN
-
Lindsay O'Kelly, LPC
-
Patricia L Payne, M.D.
-
Shayla Skahill, LPC
-
Robert Vadnal, MD
-
Ashley Weycer, RN
-
Melissa Kallweit, LCPC-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040331000194 | CO | Part B Supplier - Clinic/Group Practice | 5193717213 |
Receives reassigned benefits from 26 practitioners 11 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Elizabeth, CO; Yuma, CO; Wray, CO; Sterling, CO; Limon, CO; Julesburg, CO; Holyoke, CO; Fort Morgan, CO… |
National Provider Directory
- Tax ID family
- Centennial Mental Healt
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
118 W 3Rd St
Julesburg, CO 80737-1542
Mailing address
211 W Main St
Sterling, CO 80751-3168
Phone (970) 522-4549
Other providers in Julesburg, CO
- William Malcolm Brown III
- Dalette Ann Carlson
- Centennial Mental Health Center
- Centennial Mental Health Center, Inc.
- Centennial Mental Health Center, Inc.
- Centennial Mental Health Center, Inc.
- Cheyenne County Hospital Association
- Cheyenne County Hospital Association Inc.
- Cheyenne County Hospital Association, Inc.
- Ronald Cooper
All providers in Julesburg, CO · Community/Behavioral Health Agency in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.