Healthcare Provider Details

I. General information

NPI: 1861303075
Provider Name (Legal Business Name): KIPCHOBE HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25263 E 2ND AVE
AURORA CO
80018-4588
US

IV. Provider business mailing address

25263 E 2ND AVE
AURORA CO
80018-4588
US

V. Phone/Fax

Practice location:
  • Phone: 720-750-3151
  • Fax:
Mailing address:
  • Phone: 303-918-0195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GAIL OLIVER
Title or Position: BILLING MANAGER
Credential:
Phone: 303-531-8211