Provider Demographics
NPI:1376243659
Name:WHITE HART PSYCHIATRIC AND MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:WHITE HART PSYCHIATRIC AND MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HUFF
Authorized Official - Last Name:NIFORATOS
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:312-718-9745
Mailing Address - Street 1:1935 N LOGAN ST APT 1204
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4447
Mailing Address - Country:US
Mailing Address - Phone:312-718-9745
Mailing Address - Fax:
Practice Address - Street 1:1633 FILLMORE ST STE 390
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1586
Practice Address - Country:US
Practice Address - Phone:720-288-1079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health