Provider Demographics
NPI:1467469312
Name:DENVER CHILDREN'S HOME
Entity Type:Organization
Organization Name:DENVER CHILDREN'S HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEA
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:303-399-4890
Mailing Address - Street 1:1501 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1028
Mailing Address - Country:US
Mailing Address - Phone:303-399-4890
Mailing Address - Fax:303-320-8619
Practice Address - Street 1:1501 ALBION ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1028
Practice Address - Country:US
Practice Address - Phone:303-399-4890
Practice Address - Fax:303-320-8619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49551322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO74035835Medicaid
CO49551OtherRCCF