Organization
HAVANA MEDICAL AND HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALIK OLASUNKANMI KUFORIJI NP (OWNER/ADMINISTRATOR)
(720) 628-4593
Entity
Organization
Contact information
Practice address
1450 S HAVANA ST STE 200, AURORA, CO 80012-4021
(720) 628-4593
Mailing address
1450 S HAVANA ST STE 200, AURORA, CO 80012-4021
(720) 628-4593
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20218235356
CERTIFICATE OF GOOD STANDING
CO
Enumeration date
04/09/2022
Last updated
04/09/2022
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