Provider Demographics
NPI:1790745800
Name:DENVER INJURY EVALUATION & TREATMENT CENTER, LTD.
Entity Type:Organization
Organization Name:DENVER INJURY EVALUATION & TREATMENT CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-753-6611
Mailing Address - Street 1:1325 S COLORADO BLVD
Mailing Address - Street 2:STE. B-206
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3303
Mailing Address - Country:US
Mailing Address - Phone:303-753-6611
Mailing Address - Fax:303-753-6067
Practice Address - Street 1:1325 S COLORADO BLVD
Practice Address - Street 2:STE. B-206
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3303
Practice Address - Country:US
Practice Address - Phone:303-753-6611
Practice Address - Fax:303-753-6067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91504Medicare ID - Type Unspecified