Provider Demographics
NPI:1356125629
Name:THECOOLLINEORG
Entity type:Organization
Organization Name:THECOOLLINEORG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GABLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN, LMFT, LAC
Authorized Official - Phone:303-357-9743
Mailing Address - Street 1:2485 TOWER AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80807-2613
Mailing Address - Country:US
Mailing Address - Phone:719-342-0586
Mailing Address - Fax:
Practice Address - Street 1:451 14TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80807-1609
Practice Address - Country:US
Practice Address - Phone:719-342-0586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THECOOLLINEORG
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty