Provider Demographics
NPI:1518375419
Name:MENTAL HEALTH CENTER OF DENVER
Entity Type:Organization
Organization Name:MENTAL HEALTH CENTER OF DENVER
Other - Org Name:MENTAL HEALTH CORPORATION OF DENVER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CONTRACT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:PIERINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-504-6778
Mailing Address - Street 1:4141 E DICKENSON PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6012
Mailing Address - Country:US
Mailing Address - Phone:303-504-6500
Mailing Address - Fax:303-782-0916
Practice Address - Street 1:4455 E 12TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2415
Practice Address - Country:US
Practice Address - Phone:303-504-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENTAL HEALTH CENTER OF DENVER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-24
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000148298Medicaid