Provider Demographics
NPI:1801620463
Name:COLORADO WEST REGIONAL MENTAL HEALTH, INC.
Entity type:Organization
Organization Name:COLORADO WEST REGIONAL MENTAL HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIPPEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-545-2746
Mailing Address - Street 1:PO BOX 3807
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-3807
Mailing Address - Country:US
Mailing Address - Phone:970-241-6023
Mailing Address - Fax:970-243-8631
Practice Address - Street 1:244 E AGATE AVE
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CO
Practice Address - Zip Code:80446
Practice Address - Country:US
Practice Address - Phone:970-887-2179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4998084Medicaid