Provider Demographics
NPI: | 1942903562 |
---|---|
Name: | CATHOLIC HEALTH INITIATIVES COLORADO |
Entity Type: | Organization |
Organization Name: | CATHOLIC HEALTH INITIATIVES COLORADO |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR, OMA |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | ANGELA |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | SKINNER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 303-673-7175 |
Mailing Address - Street 1: | PO BOX 800022 |
Mailing Address - Street 2: | |
Mailing Address - City: | KANSAS CITY |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 64180-0022 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 800-953-0104 |
Mailing Address - Fax: | 303-765-6670 |
Practice Address - Street 1: | 3460 S 4155 W |
Practice Address - Street 2: | |
Practice Address - City: | WEST VALLEY CITY |
Practice Address - State: | UT |
Practice Address - Zip Code: | 84120 |
Practice Address - Country: | US |
Practice Address - Phone: | 801-964-3111 |
Practice Address - Fax: | 801-964-3752 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-03-23 |
Last Update Date: | 2023-03-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103TP0016X | Behavioral Health & Social Service Providers | Psychologist | Prescribing (Medical) | Group - Multi-Specialty |