Healthcare Provider Details

I. General information

NPI: 1356080535
Provider Name (Legal Business Name): EDHEALTH, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 16TH ST STE 1400
DENVER CO
80202-5275
US

IV. Provider business mailing address

110 16TH ST STE 1400
DENVER CO
80202-5275
US

V. Phone/Fax

Practice location:
  • Phone: 844-387-2476
  • Fax: 844-387-2476
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAMS ALVAREZ
Title or Position: ASSOCIATE
Credential: ETC.
Phone: 844-387-2476