# PORTERCARE ADVENTIST HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Interwest Rehab - PMR, Interwest Rehab - PMR, NSSD NEURO REHAB
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104494210
- **Authorized official:** MR. JASON TACHA (COO)
- **Authorized official phone:** (303) 304-7752

## Contact information

- **Practice address:** 7780 S BROADWAY STE 350, LITTLETON, CO 80122-2641
- **Practice address phone:** (720) 638-7500
- **Practice address fax:** (720) 583-6670
- **Mailing address:** PO BOX 713425, CHICAGO, IL 60677-4325
- **Mailing address phone:** (800) 953-0104
- **Mailing address fax:** (303) 765-6670

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2021
- **Last updated:** 08/12/2026