Healthcare Provider Details
I. General information
NPI: 1144053794
Provider Name (Legal Business Name): GRIFFITH CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2024
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17 FARRAGUT AVE
COLORADO SPRINGS CO
80909-5625
US
IV. Provider business mailing address
10190 BANNOCK ST STE 120
NORTHGLENN CO
80260-6052
US
V. Phone/Fax
- Phone: 719-636-2122
- Fax: 719-636-1116
- Phone: 720-230-3437
- Fax: 303-237-6873
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ESTHER
TORREZ
Title or Position: CONTROLLER
Credential: BA
Phone: 720-230-3437