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Organization

STOUT STREET FOUNDATION

Active
Other names
Serenity
Organization subpart
No

Provider details

NPI number
Authorized official
KATIE BRYDON LCSW, LAC (SUPERVISOR)
(720) 401-2340
Entity
Organization

Contact information

Practice address
7201 E 49TH AVE, COMMERCE CITY, CO 80022-4714
(303) 321-2533
(303) 468-6184
Mailing address
7201 E 49TH AVE, COMMERCE CITY, CO 80022-4714
(303) 321-2533
(303) 468-6199

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
261QM1300X
Multi-Specialty Clinic/Center
261QR0400X
Rehabilitation Clinic/Center
324500000X
Substance Abuse Rehabilitation Facility
Primary
139909
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000187465
CO
Enumeration date
01/14/2014
Last updated
10/16/2025
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