Organization
COLORADO COMMUNITY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIVAN WILSON PSYD (CEO)
(720) 504-3033
Entity
Organization
Contact information
Practice address
5701 E EVANS AVE UNIT 100, DENVER, CO 80222-5308
(505) 260-9917
Mailing address
5701 E EVANS AVE UNIT 100, DENVER, CO 80222-5308
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
08/29/2024
Last updated
08/29/2024
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