Provider Demographics
NPI:1609218320
Name:HEARING REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:HEARING REHABILITATION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILKEN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:303-984-4414
Mailing Address - Street 1:8321 SANGRE DE CRISTO RD
Mailing Address - Street 2:STE 202
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6425
Mailing Address - Country:US
Mailing Address - Phone:303-984-4414
Mailing Address - Fax:303-984-6244
Practice Address - Street 1:2018 35TH AVE
Practice Address - Street 2:UNIT A
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-3966
Practice Address - Country:US
Practice Address - Phone:970-330-7374
Practice Address - Fax:970-330-7308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty