Provider Demographics
NPI: | 1013469758 |
---|---|
Name: | NORTH METRO COMMUNITY SERVICES, INC |
Entity Type: | Organization |
Organization Name: | NORTH METRO COMMUNITY SERVICES, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ASST EXEC DIR/CFO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | GEORGE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MONTOYA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 303-453-3338 |
Mailing Address - Street 1: | 1001 W 124TH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | WESTMINSTER |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80234-1705 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 303-453-3338 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 991 PLATTE RIVER BLVD |
Practice Address - Street 2: | |
Practice Address - City: | BRIGHTON |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80601-4352 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-457-1001 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-10-28 |
Last Update Date: | 2021-06-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251C00000X | Agencies | Day Training, Developmentally Disabled Services |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CO | 23175061 | Medicaid |