Provider Demographics
NPI:1578003687
Name:EXTENDED HANDS OF HOPE
Entity Type:Organization
Organization Name:EXTENDED HANDS OF HOPE
Other - Org Name:AVANTI HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CATLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-720-3121
Mailing Address - Street 1:PO BOX 1938
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80038-1938
Mailing Address - Country:US
Mailing Address - Phone:720-935-0025
Mailing Address - Fax:
Practice Address - Street 1:8120 SHERIDAN BLVD
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-6104
Practice Address - Country:US
Practice Address - Phone:720-935-0025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000191784Medicaid