Healthcare Provider Details

I. General information

NPI: 1326972498
Provider Name (Legal Business Name): LUTHERAN SOCIAL SERVICE OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E SAINT VRAIN ST STE 21
COLORADO SPRINGS CO
80903-1161
US

IV. Provider business mailing address

1035 OSAGE ST STE 700
DENVER CO
80204-4209
US

V. Phone/Fax

Practice location:
  • Phone: 303-922-3433
  • Fax:
Mailing address:
  • Phone:
  • 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: JENNIFER BOHANNON
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 970-266-1146