Organization
WIICARE COLORADO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAWAL MOHAMMAD (CEO)
(804) 469-0044
Entity
Organization
Contact information
Practice address
1642 S PARKER RD STE 307, DENVER, CO 80231-2917
(480) 452-9149
Mailing address
1501 W EMERALD KEY CT, GILBERT, AZ 85233-6114
(482) 452-9149
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2887-BHE001
COLORADO BEHAVIORAL HEALTH ADMINISTRATION
CO
Enumeration date
08/21/2024
Last updated
08/21/2024
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