# MT. ST. VINCENT HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770602799
- **Authorized official:** MR. KIRK DAMON WARD LCSW (CLINICAL DIRECTOR)
- **Authorized official phone:** (303) 458-7220

## Contact information

- **Practice address:** 4159 LOWELL BLVD, DENVER, CO 80211-1658
- **Practice address phone:** (303) 458-7220
- **Practice address fax:** (303) 477-7559
- **Mailing address:** 4159 LOWELL BLVD, DENVER, CO 80211-1658
- **Mailing address phone:** (303) 458-7220
- **Mailing address fax:** (303) 477-7559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 991248 | CO | Yes |

## Other

- **Enumeration date:** 03/29/2007
- **Last updated:** 02/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 94381330 | — | CO |