Provider Demographics
NPI:1740923051
Name:COLORADO HEALTH NETWORK, INC
Entity type:Organization
Organization Name:COLORADO HEALTH NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICES OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LILI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-945-2381
Mailing Address - Street 1:6260 E COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1515
Mailing Address - Country:US
Mailing Address - Phone:303-837-1501
Mailing Address - Fax:303-837-0388
Practice Address - Street 1:6260 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1515
Practice Address - Country:US
Practice Address - Phone:303-863-0772
Practice Address - Fax:303-832-7823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty