Provider Demographics
NPI:1578773214
Name:ASIAN PACIFIC CENTER FOR HUMAN DEVELOPMENT
Entity Type:Organization
Organization Name:ASIAN PACIFIC CENTER FOR HUMAN DEVELOPMENT
Other - Org Name:ASIAN PACIFIC DEVELOPMENT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUDISIDHARTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-923-2920
Mailing Address - Street 1:1290 CHAMBERS RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-7117
Mailing Address - Country:US
Mailing Address - Phone:303-617-2300
Mailing Address - Fax:
Practice Address - Street 1:1537 ALTON ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-1712
Practice Address - Country:US
Practice Address - Phone:303-617-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04001160Medicaid