Provider Demographics
NPI:1821501651
Name:COLORADO TREATMENT SERVICES, LLC
Entity Type:Organization
Organization Name:COLORADO TREATMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PERLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ-GROOTHUIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LAC
Authorized Official - Phone:469-442-5314
Mailing Address - Street 1:7136 S YALE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6373
Mailing Address - Country:US
Mailing Address - Phone:719-569-7796
Mailing Address - Fax:
Practice Address - Street 1:275 W ABRIENDO AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-1870
Practice Address - Country:US
Practice Address - Phone:719-569-7796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLORADO TREATMENT SERVICES, LLC GREELEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-15
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1648-02261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone