Provider Demographics
NPI:1255980959
Name:MILE HIGH COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Entity type:Organization
Organization Name:MILE HIGH COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-975-0155
Mailing Address - Street 1:PO BOX 919
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80040-0919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3460 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:CO
Practice Address - Zip Code:80110-1967
Practice Address - Country:US
Practice Address - Phone:303-761-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MILE HIGH COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-05
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable