Organization
JEFFERSON CENTER FOR MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A GOFF (CHIEF FINANCIAL OFFICER)
(303) 432-5164
Entity
Organization
Contact information
Practice address
4851 INDEPENDENCE ST, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
(303) 432-5071
Mailing address
4851 INDEPENDENCE ST STE 200, WHEAT RIDGE, CO 80033-6712
(303) 425-0300
(303) 432-5071
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
560
CO
251S00000X
Community/Behavioral Health Agency
560
CO
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000130227
—
CO
Enumeration date
10/20/2006
Last updated
01/13/2021
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