Provider Demographics
NPI:1205087582
Name:OUTPATIENT BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:OUTPATIENT BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD ADDICTIONS COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:CAC III
Authorized Official - Phone:303-436-3186
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4507
Mailing Address - Country:US
Mailing Address - Phone:303-436-3186
Mailing Address - Fax:303-436-6204
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-3186
Practice Address - Fax:303-436-6204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6656282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital