Provider Demographics
NPI:1245861152
Name:ATLANTIS COMMUNITY INC
Entity type:Organization
Organization Name:ATLANTIS COMMUNITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-733-9324
Mailing Address - Street 1:420 W CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-1872
Mailing Address - Country:US
Mailing Address - Phone:303-733-9324
Mailing Address - Fax:
Practice Address - Street 1:420 W CEDAR AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1872
Practice Address - Country:US
Practice Address - Phone:303-733-9324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management