Provider Demographics
NPI:1760003669
Name:ARRAY CLINICAL AND THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:ARRAY CLINICAL AND THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CDO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY ORDWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-824-9350
Mailing Address - Street 1:451 21ST AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-1483
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1349 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4726
Practice Address - Country:US
Practice Address - Phone:800-440-1652
Practice Address - Fax:970-775-8107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty