Provider Demographics
NPI:1912107491
Name:CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type:Organization
Organization Name:CATHOLIC HEALTH INITIATIVES COLORADO
Other - Org Name:ST MARY CORWIN HEALTH PROMOTIONS CENTER REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST. VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-486-5504
Mailing Address - Street 1:DEPT 1188
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1188
Mailing Address - Country:US
Mailing Address - Phone:303-486-5504
Mailing Address - Fax:303-486-5502
Practice Address - Street 1:1008 MINNEQUA AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-3733
Practice Address - Country:US
Practice Address - Phone:719-557-5417
Practice Address - Fax:719-557-4750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225100000X, 225200000X, 225500000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO=========OtherTIN