1144336512 NPI number — CATHOLIC HEALTH INITIATIVES COLORADO

Table of content: (NPI 1144336512)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144336512 NPI number — CATHOLIC HEALTH INITIATIVES COLORADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATHOLIC HEALTH INITIATIVES COLORADO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PENROSE-ST.FRANCIS HEALTH SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144336512
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2222 N NEVADA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80907-6819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-776-5111
Provider Business Mailing Address Fax Number:
719-776-2770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 E PIKES PEAK AVE
Provider Second Line Business Practice Location Address:
CENTER FOR BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80903-3635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-776-8335
Provider Business Practice Location Address Fax Number:
719-776-8568
Provider Enumeration Date:
08/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
O'CONNELL
Authorized Official First Name:
RICK
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
719-776-5111

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  354 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05031000 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".