# CATHOLIC HEALTH INITIATIVES COLORADO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Centura Health Physician Group Tri-Lakes Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497157960
- **Authorized official:** ANGELA SKINNER (OMA ADMINISTRATOR)
- **Authorized official phone:** (303) 673-7175

## Contact information

- **Practice address:** 17230 JACKSON CREEK PKWY, SUITE 300, MONUMENT, CO 80132-7301
- **Practice address phone:** (719) 571-7000
- **Practice address fax:** (719) 571-7059
- **Mailing address:** PO BOX 911057, DENVER, CO 80291-1057
- **Mailing address phone:** (303) 643-1099
- **Mailing address fax:** (303) 643-1176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2014
- **Last updated:** 04/20/2016