Provider Demographics
NPI:1275654527
Name:ROCKY MOUNTAIN HUMAN SERVICES MOMENTUM PROGRAM
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN HUMAN SERVICES MOMENTUM PROGRAM
Other - Org Name:DENVER OPTIONS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WATHERINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-636-5796
Mailing Address - Street 1:9900 E ILIFF AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-3462
Mailing Address - Country:US
Mailing Address - Phone:303-636-5762
Mailing Address - Fax:303-636-5644
Practice Address - Street 1:9900 E ILIFF AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231
Practice Address - Country:US
Practice Address - Phone:303-636-5600
Practice Address - Fax:303-636-5607
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCKY MOUNTAIN HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-03
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000142044Medicaid