Healthcare Provider Details

I. General information

NPI: 1144323536
Provider Name (Legal Business Name): CATHOLIC HEALTH INIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 08/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 E PIKES PEAK AVE
COLORADO SPRINGS CO
80903-3635
US

IV. Provider business mailing address

DEPT 1193
DENVER CO
80291-1193
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-8325
  • Fax: 719-776-8568
Mailing address:
  • Phone: 303-486-5504
  • Fax: 303-486-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMY HANNA
Title or Position: ASST VP FINANCE
Credential:
Phone: 303-804-8189