Organization
MOUNTAIN FAMILY HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROSS A BROOKS (CEO)
(970) 945-2840
Entity
Organization
Contact information
Practice address
562 GREGORY STREET, BLACK HAWK, CO 80422
(303) 582-5276
(303) 582-1003
Mailing address
1905 BLAKE AVE, SUITE 101, GLENWOOD SPRINGS, CO 81601-4288
(970) 945-2840
(970) 945-2893
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
0040
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05600812
—
CO
Enumeration date
12/19/2006
Last updated
11/13/2013
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