Provider Demographics
NPI:1821820549
Name:FEET FORWARD - PEER SERVICES AND OUTREACH
Entity type:Organization
Organization Name:FEET FORWARD - PEER SERVICES AND OUTREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZATIONAL CONSTULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-840-2443
Mailing Address - Street 1:1043 E 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5201
Mailing Address - Country:US
Mailing Address - Phone:720-840-2443
Mailing Address - Fax:
Practice Address - Street 1:1212 CANYON BLVD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302
Practice Address - Country:US
Practice Address - Phone:720-520-2097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty