1821835562 NPI number — MENTAL HEALTH CENTER OF DENVER

Table of content: (NPI 1821835562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821835562 NPI number — MENTAL HEALTH CENTER OF DENVER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MENTAL HEALTH CENTER OF DENVER
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:
6
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:
1821835562
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4141 E DICKENSON 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:
80222-6012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1450 S ASH ST
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:
80222-3629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-759-2673
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2024

Additional Information

Authorized Official

Authorized Official Last Name:
BURR
Authorized Official First Name:
MIA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PAYER STRATEGIES
Authorized Official Telephone Number:
650-770-0603

Provider Taxonomy Codes

  • Taxonomy code: 320800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3135098 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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