Provider Demographics
NPI:1912379306
Name:CENTER FOR HEALING TRAUMA AND ATTACHMENT, INC.
Entity Type:Organization
Organization Name:CENTER FOR HEALING TRAUMA AND ATTACHMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCC, LPC
Authorized Official - Phone:970-397-4609
Mailing Address - Street 1:3055 COUNTY ROAD L
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:CO
Mailing Address - Zip Code:80654-8121
Mailing Address - Country:US
Mailing Address - Phone:970-397-4609
Mailing Address - Fax:970-483-7823
Practice Address - Street 1:411 MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-2136
Practice Address - Country:US
Practice Address - Phone:970-397-4609
Practice Address - Fax:970-483-7823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-23
Last Update Date:2016-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC4495101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty