Healthcare Provider Details

I. General information

NPI: 1992171219
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1263 LAKE PLAZA DR SUITE 230
COLORADO SPRINGS CO
80906-3564
US

IV. Provider business mailing address

PO BOX 911057
DENVER CO
80291-1057
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-3300
  • Fax: 719-776-3329
Mailing address:
  • Phone: 303-643-1099
  • Fax: 303-643-1176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA SKINNER
Title or Position: OMA / ADMINISTRATOR
Credential:
Phone: 303-673-7175