Organization
MT. ST. VINCENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIRK DAMON WARD LCSW (CLINICAL DIRECTOR)
(303) 458-7220
Entity
Organization
Contact information
Practice address
4159 LOWELL BLVD, DENVER, CO 80211-1658
(303) 458-7220
(303) 477-7559
Mailing address
4159 LOWELL BLVD, DENVER, CO 80211-1658
(303) 458-7220
(303) 477-7559
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
991248
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94381330
—
CO
Enumeration date
03/29/2007
Last updated
02/01/2008
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