Provider Demographics
NPI:1649733163
Name:GILPIN COUNTY
Entity type:Organization
Organization Name:GILPIN COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKAHASHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-582-5444
Mailing Address - Street 1:2960 DORY HILL RD UNIT 100
Mailing Address - Street 2:
Mailing Address - City:BLACK HAWK
Mailing Address - State:CO
Mailing Address - Zip Code:80422-8771
Mailing Address - Country:US
Mailing Address - Phone:303-582-5444
Mailing Address - Fax:303-582-5798
Practice Address - Street 1:2960 DORY HILL RD UNIT 100
Practice Address - Street 2:
Practice Address - City:BLACK HAWK
Practice Address - State:CO
Practice Address - Zip Code:80422-8771
Practice Address - Country:US
Practice Address - Phone:303-582-5444
Practice Address - Fax:303-582-5798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency