Provider Demographics
NPI:1568220622
Name:COLORADO THERAPY & ASSESSMENT CENTER
Entity Type:Organization
Organization Name:COLORADO THERAPY & ASSESSMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-450-6520
Mailing Address - Street 1:1777 S BELLAIRE ST STE 390
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4350
Mailing Address - Country:US
Mailing Address - Phone:720-450-6520
Mailing Address - Fax:
Practice Address - Street 1:10 W BROADWAY FL 7
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-2060
Practice Address - Country:US
Practice Address - Phone:720-515-4244
Practice Address - Fax:720-441-0448
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLORADO THERAPY & ASSESSMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty