Organization
INN BETWEEN
Active
Parent organization
JEFFERSON CENTER FOR MENTAL HEALTH
Other names
Jefferson Center for Mental Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
JEFFERSON CENTER FOR MENTAL HEALTH
Authorized official
DAVID A GOFF (CHIEF FINANCIAL OFFICER)
(303) 432-5164
Entity
Organization
Contact information
Practice address
10295 W KEENE AVE, LAKEWOOD, CO 80235-1104
(303) 980-4082
(303) 980-4084
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
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
150413
CO
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45175233
—
CO
05
—
9000175762
—
CO
Enumeration date
04/02/2009
Last updated
12/18/2020
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