Provider Demographics
NPI:1841518404
Name:IDEA FORUM INC.
Entity type:Organization
Organization Name:IDEA FORUM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AVINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-477-8280
Mailing Address - Street 1:2370 W ALAMEDA AVE UNIT 8
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-1991
Mailing Address - Country:US
Mailing Address - Phone:303-477-8280
Mailing Address - Fax:303-477-1369
Practice Address - Street 1:2370 W ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1991
Practice Address - Country:US
Practice Address - Phone:303-477-8280
Practice Address - Fax:303-477-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health