Provider Demographics
NPI:1063838761
Name:MILE HIGH WOMEN'S OUTREACH CENTER
Entity Type:Organization
Organization Name:MILE HIGH WOMEN'S OUTREACH CENTER
Other - Org Name:MHWOC
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-880-8891
Mailing Address - Street 1:3602 S JASON ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-3431
Mailing Address - Country:US
Mailing Address - Phone:720-880-8891
Mailing Address - Fax:
Practice Address - Street 1:3602 S JASON ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-3431
Practice Address - Country:US
Practice Address - Phone:720-880-8891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty