Organization
THE MOUNTAIN STAR CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAT FOO (HIPAA OFFICER)
(303) 866-5871
Entity
Organization
Contact information
Practice address
3520 W OXFORD AVE, DENVER, CO 80236-3108
(303) 866-7080
(303) 866-7088
Mailing address
1600 W 24TH ST, PUEBLO, CO 81003-1411
(719) 546-4000
(719) 546-4484
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
13363
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18751067
—
CA
Enumeration date
03/14/2007
Last updated
08/22/2020
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