Provider Demographics
NPI:1790447985
Name:KIDS FIRST HEALTH CARE
Entity Type:Organization
Organization Name:KIDS FIRST HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR ADMINISTRATION & FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LURIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-853-3282
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 1:6500 EAST 72ND AVE
Practice Address - Street 2:LESTER ARNOLD HIGH SCHOOL
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022
Practice Address - Country:US
Practice Address - Phone:303-853-3310
Practice Address - Fax:303-289-7167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO73105091Medicaid