# JEFFERSON CENTER FOR MENTAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blue Spruce Pharmacy at Independence
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013373679
- **Authorized official:** MR. ANDREW VANDER KOOI PHARMD (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (303) 432-5725

## Contact information

- **Practice address:** 4851 INDEPENDENCE ST, WHEAT RIDGE, CO 80033-6715
- **Practice address phone:** (303) 432-5725
- **Practice address fax:** (303) 432-5724
- **Mailing address:** 4851 INDEPENDENCE ST, WHEAT RIDGE, CO 80033-6715
- **Mailing address phone:** (303) 432-5725
- **Mailing address fax:** (303) 432-5724

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 1680000103 | CO | Yes |
| 3336C0002X | Clinic Pharmacy | — | — | — |
| 3336C0003X | Community/Retail Pharmacy | — | — | — |
| 3336L0003X | Long Term Care Pharmacy | — | — | — |

## Other

- **Enumeration date:** 01/12/2016
- **Last updated:** 10/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 04680057 | — | CO |
| 01 | — | 2157466 | PK | — |