Provider Demographics
NPI:1659937290
Name:OPERATION TRUE NORTH COLORADO, LLC
Entity Type:Organization
Organization Name:OPERATION TRUE NORTH COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:303-800-4605
Mailing Address - Street 1:5445 DTC PKWY PH 4
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3059
Mailing Address - Country:US
Mailing Address - Phone:303-800-4605
Mailing Address - Fax:
Practice Address - Street 1:5445 DTC PKWY PH 4
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3059
Practice Address - Country:US
Practice Address - Phone:303-800-4605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty