Organization
IDEA-THORNTON
Active
Parent organization
IDEA FORUM INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
IDEA FORUM INC.
Authorized official
MIGUEL AVINA (COO)
(303) 477-8280
Entity
Organization
Contact information
Practice address
9051 WASHINGTON ST, THORNTON, CO 80229-4335
(303) 996-9966
Mailing address
9051 WASHINGTON ST, THORNTON, CO 80229-4335
(303) 996-9966
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000149330
—
CO
Enumeration date
12/27/2010
Last updated
05/14/2024
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