Healthcare Provider Details

I. General information

NPI: 1205755063
Provider Name (Legal Business Name): LUIS ALEXIS CORDOVA HINOJOS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 SMITH RD
DENVER CO
80216-4631
US

IV. Provider business mailing address

6100 SMITH RD
DENVER CO
80216-4631
US

V. Phone/Fax

Practice location:
  • Phone: 303-297-1815
  • Fax:
Mailing address:
  • Phone: 303-297-1815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACA.0008585
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: