Provider Demographics
NPI:1265763866
Name:PORTERCARE ADVENTIST HOSPITAL/CENURA HEALTH
Entity type:Organization
Organization Name:PORTERCARE ADVENTIST HOSPITAL/CENURA HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PEPCS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-778-2563
Mailing Address - Street 1:2465 S DOWNING ST STE 110
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5822
Mailing Address - Country:US
Mailing Address - Phone:303-765-6970
Mailing Address - Fax:
Practice Address - Street 1:2465 S DOWNING ST STE 110
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5822
Practice Address - Country:US
Practice Address - Phone:303-765-6970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5507282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital