Provider Demographics
NPI:1952157547
Name:JEFFERSON COUNTY
Entity Type:Organization
Organization Name:JEFFERSON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMA DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:303-601-3083
Mailing Address - Street 1:900 JEFFERSON COUNTY PKWY
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-6001
Mailing Address - Country:US
Mailing Address - Phone:303-601-3083
Mailing Address - Fax:
Practice Address - Street 1:900 JEFFERSON COUNTY PKWY
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-6001
Practice Address - Country:US
Practice Address - Phone:303-601-3083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-25
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management