1386161180 NPI number — GEO REENTRY SERVICES

Table of content: (NPI 1386161180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386161180 NPI number — GEO REENTRY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GEO REENTRY SERVICES
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:
Provider Other Organization Name Type Code:
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:
1386161180
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1359 COURT PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80204-2108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-832-1144
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1359 COURT PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80204-2108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-842-3632
Provider Business Practice Location Address Fax Number:
303-842-3632
Provider Enumeration Date:
08/23/2017

Additional Information

Authorized Official

Authorized Official Last Name:
HORRIGAN
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
C
Authorized Official Title or Position:
AREA MANAGER
Authorized Official Telephone Number:
303-842-3632

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 276400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1280-00 . This is a "OFFICE OF BEHAVIORAL HEALTH" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1280-04 . This is a "OFFICE OF BEHAVIORAL HEALTH" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1280-03 . This is a "OFFICE OF BEHAVIORAL HEALTH" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1280-01 . This is a "OFFICE OF BEHAVIORAL HEALTH" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com