Provider Demographics
NPI:1710968417
Name:BRAIN MATTERS, INC.
Entity Type:Organization
Organization Name:BRAIN MATTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO AND CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-941-6428
Mailing Address - Street 1:201 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4657
Mailing Address - Country:US
Mailing Address - Phone:720-941-6428
Mailing Address - Fax:720-941-6494
Practice Address - Street 1:201 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4657
Practice Address - Country:US
Practice Address - Phone:720-941-6428
Practice Address - Fax:720-941-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2831040261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology