SOUTHEAST MENTAL HEALTH SERVICES (NPI# 1417945254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417945254 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST MENTAL HEALTH SERVICES |
| Practice Address |
711 Barnes Ave La Junta CO 81050-2138 |
| Practice Telephone | 7193845446 |
| Practice Fax Number | 7193845672 |
| Mailing Telephone | 7193845446 |
| Mailing Fax Number | 7193845672 |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | CAROL ARAGON (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 7193845446 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
0426 | CO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 04160099 | 05 | |
| CO | MEDICAID CAPITATION PROGR | 4034013 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386280907 | Southeast Mental Health Services | Clinic/Center | 910 W 3rd St, La Junta, CO 81050-1315 | 2019-11-19 |
| 1033752928 | Southeast Mental Health Services | Clinic/Center | 613 Barnes Ave, La Junta, CO 81050-2136 | 2019-10-23 |
| 1699317867 | Southeast Mental Health Services | Clinic/Center | 963 Elm Ave, Rocky Ford, CO 81067-1335 | 2019-10-09 |
| 1437791605 | Southeast Mental Health Services | Clinic/Center | 113 W Elm St, Lamar, CO 81052-2701 | 2019-10-09 |
| 1801438056 | Southeast Mental Health Services | Clinic/Center | 117 W Elm St, Lamar, CO 81052-2701 | 2019-10-09 |
| 1316589567 | Southeast Mental Health Services | Clinic/Center | 721 Barnes Ave, La Junta, CO 81050 | 2019-10-09 |
| 1184265985 | Southeast Mental Health Services | Clinic/Center | 101 E Lowell St, Eads, CO 81036-9683 | 2019-10-02 |
| 1295366177 | Southeast Mental Health Services | Clinic/Center | 711 Barnes Ave, La Junta, CO 81050-2138 | 2020-01-30 |
| 1942843834 | Southeast Mental Health Services | Clinic/Center | 214 Ash St, La Junta, CO 81050-9598 | 2019-10-23 |
| 1558903708 | Southeast Mental Health Services | Clinic/Center | 302 Barnes Ave, La Junta, CO 81050-1329 | 2019-10-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | SOUTHEAST MENTAL HEALTH SERVICES | 711 Barnes Ave, La Junta, CO 81050 |
| Street Address |
711 BARNES AVE |
| City | LA JUNTA |
| State | CO |
| Zip Code | 81050-2138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205446010 | Briana Christina Lynn | Social Worker | 711 Barnes Ave, La Junta, CO 81050-2138 | 2020-08-06 |
| 1841811254 | Brianne Dickinson | Registered Nurse | 711 Barnes Ave, La Junta, CO 81050-2138 | 2020-04-27 |
| 1306467717 | Angelique Chavez | Registered Nurse | 711 Barnes Ave, La Junta, CO 81050-2138 | 2020-04-27 |
| 1295366177 | Southeast Mental Health Services | Clinic/Center | 711 Barnes Ave, La Junta, CO 81050-2138 | 2020-01-30 |
| 1477195170 | Jonathon Michael Melendez | Counselor | 711 Barnes Ave, La Junta, CO 81050-2138 | 2019-10-14 |
| 1245880848 | Martin Valdez | Case Manager/Care Coordinator | 711 Barnes Ave, La Junta, CO 81050-2138 | 2019-09-16 |
| 1528611712 | Shana Se'rae Santistevan | Registered Nurse | 711 Barnes Ave, La Junta, CO 81050-2138 | 2019-07-17 |
| 1538624523 | Richard Keck | Case Manager/Care Coordinator | 711 Barnes Ave, La Junta, CO 81050-2138 | 2019-02-05 |
| 1396218475 | Austin Coy | Case Manager/Care Coordinator | 711 Barnes Ave, La Junta, CO 81050-2138 | 2019-01-10 |
| 1053884130 | Adam Schafer | Counselor | 711 Barnes Ave, La Junta, CO 81050-2138 | 2019-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225658057 | Poudre Valley Medical Group, LLC | Internal Medicine | 2315 San Juan Avenue, La Junta, CO 81050 | 2020-04-22 |
| 1316589567 | Southeast Mental Health Services | Clinic/Center | 721 Barnes Ave, La Junta, CO 81050 | 2019-10-09 |
| 1164945127 | Susan Ann Workman | Clinical Nurse Specialist | 13 West Third Street, Room 111, La Junta, CO 81050 | 2017-07-21 |
| 1952774465 | Ryan T Anderson Ddc PC | Clinic/Center | 13 E 4th St., La Junta, CO 81050 | 2015-11-05 |
| 1083086524 | Ryan Taylor Anderson | Dentist | 13 East 4th Street, La Junta, CO 81050 | 2015-10-23 |
| 1902287329 | Shanna Kay Riley | Case Manager/Care Coordinator | 711 Barnes Ave., La Junta, CO 81050 | 2015-06-11 |
| 1548668593 | Joseph Wayne Lee | Licensed Practical Nurse | 1203 Holt Ln, Lajunta, CO 81050 | 2014-12-08 |
| 1730506809 | Down To Earth Dentistry, LLC. | Dentist | 17 W. 4th St., La Junta, CO 81050 | 2014-03-26 |
| 1154668275 | Arkansas Valley Hearing Center, Inc | Hearing Aid Equipment | 408 West 3rd St, La Junta, CO 81050 | 2013-01-09 |
| 1710223698 | Timothy Eugene Kelley | Counselor | 313 West Third Street, Suite 204, La Junta, CO 81050 | 2012-12-20 |
| Find all providers in zip 81050 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386280907 | Southeast Mental Health Services | Clinic/Center | 910 W 3rd St, La Junta, CO 81050-1315 | 2019-11-19 |
| 1033752928 | Southeast Mental Health Services | Clinic/Center | 613 Barnes Ave, La Junta, CO 81050-2136 | 2019-10-23 |
| 1942843834 | Southeast Mental Health Services | Clinic/Center | 214 Ash St, La Junta, CO 81050-9598 | 2019-10-23 |
| 1558903708 | Southeast Mental Health Services | Clinic/Center | 302 Barnes Ave, La Junta, CO 81050-1329 | 2019-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225336 | Wellcova Health Services | Clinic/Center | 90 Madison St Ste 703, Denver, CO 80206-5416 | 2020-11-04 |
| 1053911354 | Midwestern Colorado Mental Health Center | Clinic/Center | 214 6th St., Suite 4, Crested Butte, CO 81224 | 2020-10-27 |
| 1780284083 | Midwestern Colorado Mental Health Center | Clinic/Center | 238 E. Colorado Ave, Suite 9, Telluride, CO 81435 | 2020-10-27 |
| 1023625621 | Spanish Clinic LLC | Clinic/Center | 1400 Dayton St, Aurora, CO 80010-3233 | 2020-09-28 |
| 1477160083 | Spanish Clinic LLC | Clinic/Center | 12445 E 39th Ave Unit 207, Denver, CO 80239-3454 | 2020-09-28 |
| 1457966228 | Community Reach Center, Inc | Clinic/Center | 11275 Highline Dr, Northglenn, CO 80233-3076 | 2020-09-09 |
| 1437763968 | Arapahoe Mental Health Center, Inc | Clinic/Center | 9235 Crown Crest Blvd Ste 125, Parker, CO 80138-8880 | 2020-09-02 |
| 1528671880 | Natural Embodiment LLC | Clinic/Center | 640 Arapahoe Ave Apt 6, Boulder, CO 80302-5920 | 2020-08-26 |
| 1457963514 | Summitstone Health Partners | Clinic/Center | 810 E 10th St, Loveland, CO 80537-4946 | 2020-08-20 |
| 1558970889 | Kelley Dyer Lcsw Inc. | Clinic/Center | 4793 N Splendid Cir, Colorado Springs, CO 80917-1681 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.