Provider Demographics
NPI:1508074303
Name:COLORADO NEUROLOGICAL INSTITUTE
Entity Type:Organization
Organization Name:COLORADO NEUROLOGICAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROHEALTH CENTER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:BELLE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:303-806-7421
Mailing Address - Street 1:701 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2759
Mailing Address - Country:US
Mailing Address - Phone:303-597-1724
Mailing Address - Fax:303-788-5469
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2759
Practice Address - Country:US
Practice Address - Phone:303-597-1724
Practice Address - Fax:303-788-5469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Multi-Specialty
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066644Medicare PIN