Organization
CATHOLIC HEALTH INITIATIVES COLORADO
Active
Other names
Centura Health Physician Group Tri-Lakes Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA SKINNER (OMA ADMINISTRATOR)
(303) 673-7175
Entity
Organization
Contact information
Practice address
17230 JACKSON CREEK PKWY, SUITE 300, MONUMENT, CO 80132-7301
(719) 571-7000
(719) 571-7059
Mailing address
PO BOX 911057, DENVER, CO 80291-1057
(303) 643-1099
(303) 643-1176
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36258857
—
CO
Enumeration date
09/16/2014
Last updated
04/20/2016
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