Organization
JEFFERSON CENTER FOR MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A GOFF (CHIEF FINANCIAL OFFICER)
(303) 432-5164
Entity
Organization
Contact information
Practice address
4643 WADSWORTH BLVD, WHEAT RIDGE, CO 80033-3305
(303) 463-7400
(303) 412-3368
Mailing address
4851 INDEPENDENCE ST STE 200, WHEAT RIDGE, CO 80033-6712
(303) 425-0300
(303) 432-5071
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
150413
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000157909
—
CO
Enumeration date
04/02/2009
Last updated
12/04/2020
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