Provider Demographics
NPI:1336807775
Name:I HAVE A DREAM FOUNDATION - COLORADO
Entity Type:Organization
Organization Name:I HAVE A DREAM FOUNDATION - COLORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIR. OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-861-5005
Mailing Address - Street 1:1836 N GRANT ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-1123
Mailing Address - Country:US
Mailing Address - Phone:303-861-5005
Mailing Address - Fax:
Practice Address - Street 1:855 S IRVING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-3420
Practice Address - Country:US
Practice Address - Phone:303-861-5005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)