Provider First Line Business Practice Location Address:
12055 W 2ND PLACE
Provider Second Line Business Practice Location Address:
JEFFERSON CTR FOR MENTAL HEALTH
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-425-0300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/11/2015