Provider Demographics
NPI:1255581120
Name:REFLECTIONS ACADEMY
Entity type:Organization
Organization Name:REFLECTIONS ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:S
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-344-1380
Mailing Address - Street 1:1000 S LINCOLN AVE
Mailing Address - Street 2:#200
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-6358
Mailing Address - Country:US
Mailing Address - Phone:970-344-1390
Mailing Address - Fax:970-344-1395
Practice Address - Street 1:1000 S LINCOLN AVE
Practice Address - Street 2:#200
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-6358
Practice Address - Country:US
Practice Address - Phone:970-344-1390
Practice Address - Fax:970-344-1395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1545846320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1545846OtherCOLORADO DEPARTMENT OF HUMAN SERVICES