Provider Demographics
NPI:1780894972
Name:MARIA DROSTE SERVICES OF COLORADO, INC.
Entity type:Organization
Organization Name:MARIA DROSTE SERVICES OF COLORADO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCKINZIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-756-9052
Mailing Address - Street 1:1355 S COLORADO BLVD
Mailing Address - Street 2:SUITE C-100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3305
Mailing Address - Country:US
Mailing Address - Phone:303-756-8052
Mailing Address - Fax:303-756-0308
Practice Address - Street 1:1355 S COLORADO BLVD
Practice Address - Street 2:SUITE C-100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3305
Practice Address - Country:US
Practice Address - Phone:303-756-8052
Practice Address - Fax:303-756-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCB4006Medicare ID - Type UnspecifiedMEDICARE NUMBER
COCOB5021Medicare PIN