Provider Demographics
NPI:1952038093
Name:SEND HEP-I
Entity Type:Organization
Organization Name:SEND HEP-I
Other - Org Name:SEND HEPI
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUMMEREUN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-679-6919
Mailing Address - Street 1:PO BOX 441021
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80044-1021
Mailing Address - Country:US
Mailing Address - Phone:714-679-6919
Mailing Address - Fax:
Practice Address - Street 1:5605 RIGGINS CT
Practice Address - Street 2:STE 200
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:714-679-6919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251X00000XAgenciesSupports Brokerage
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No305S00000XManaged Care OrganizationsPoint of Service