Organization
STATE OF COLORADO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYN SNOW (COMPLIANCE OFFICER)
(303) 866-7149
Entity
Organization
Contact information
Practice address
1575 SHERMAN STREET, CDHS, DENVER, CO 80203
(303) 866-7149
Mailing address
1575 SHERMAN STREET, CDHS, DENVER, CO 80203
(303) 866-7149
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
302302
MN
305S00000X
Point of Service
Primary
727
CO
305S00000X
Point of Service
LPC0011949
CO
Other
Enumeration date
04/13/2017
Last updated
07/21/2022
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