Provider Demographics
NPI:1093075491
Name:METRO COMMUNITY PROVIDER NETWORK INC
Entity Type:Organization
Organization Name:METRO COMMUNITY PROVIDER NETWORK INC
Other - Org Name:STRIDE COMMUNITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR OF OE/BI
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-761-1977
Mailing Address - Street 1:2255 S ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2522
Mailing Address - Country:US
Mailing Address - Phone:303-761-1977
Mailing Address - Fax:303-343-0247
Practice Address - Street 1:11005 RALSTON RD STE 100G
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-4551
Practice Address - Country:US
Practice Address - Phone:303-360-6276
Practice Address - Fax:303-789-7222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METRO COMMUNITY PROVIDER NETWORK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-21
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QF0400X, 261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)