Provider Demographics
NPI:1629196324
Name:METROPOLITAN STATE UNIVERSITY OF DENVER
Entity Type:Organization
Organization Name:METROPOLITAN STATE UNIVERSITY OF DENVER
Other - Org Name:HEALTH CENTER AT AURARIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LASSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-615-1949
Mailing Address - Street 1:PO BOX 173362
Mailing Address - Street 2:CB 20
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-3362
Mailing Address - Country:US
Mailing Address - Phone:303-615-9999
Mailing Address - Fax:720-778-5850
Practice Address - Street 1:955 LAWRENCE WAY
Practice Address - Street 2:SUITE 150
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204
Practice Address - Country:US
Practice Address - Phone:303-615-9999
Practice Address - Fax:720-778-5850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCBM2052835261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center