Provider Demographics
NPI:1831643444
Name:1ST ALLIANCE TREATMENT SERVICES
Entity Type:Organization
Organization Name:1ST ALLIANCE TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TASC PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ISACCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-771-5552
Mailing Address - Street 1:8787 TURNPIKE DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7031
Mailing Address - Country:US
Mailing Address - Phone:720-771-5552
Mailing Address - Fax:720-214-0856
Practice Address - Street 1:8787 TURNPIKE DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-7031
Practice Address - Country:US
Practice Address - Phone:720-214-0826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1326436932Medicaid