Provider Demographics
NPI:1235186362
Name:NAVITAS COLORADO, LLC
Entity Type:Organization
Organization Name:NAVITAS COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-865-7840
Mailing Address - Street 1:8774 YATES DR
Mailing Address - Street 2:SHERIDAN PARK PLACE, SUITE 150
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6958
Mailing Address - Country:US
Mailing Address - Phone:303-426-4633
Mailing Address - Fax:303-426-7256
Practice Address - Street 1:8774 YATES DR
Practice Address - Street 2:SHERIDAN PARK PLACE, SUITE 150
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-6958
Practice Address - Country:US
Practice Address - Phone:303-426-4633
Practice Address - Fax:303-426-7256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO064518Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
066631Medicare ID - Type Unspecified