Provider Demographics
NPI:1639200702
Name:KIDS FIRST HEALTH CARE
Entity Type:Organization
Organization Name:KIDS FIRST HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:GUSTIN
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-289-1086
Mailing Address - Street 1:7190 COLORADO BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-1847
Mailing Address - Country:US
Mailing Address - Phone:303-289-1086
Mailing Address - Fax:303-289-7378
Practice Address - Street 1:7190 COLORADO BLVD STE 450
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-1847
Practice Address - Country:US
Practice Address - Phone:303-289-1086
Practice Address - Fax:303-289-7378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0420261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04000188Medicaid