Healthcare Provider Details

I. General information

NPI: 1184745432
Provider Name (Legal Business Name): ROCKY MOUNTAIN HUMAN SERVICES TRANSITION SPECIALIST PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 E ILIFF AVE
DENVER CO
80231
US

IV. Provider business mailing address

9900 E ILIFF AVE
DENVER CO
80231-3462
US

V. Phone/Fax

Practice location:
  • Phone: 303-636-5600
  • Fax: 303-636-5607
Mailing address:
  • Phone: 303-636-5762
  • Fax: 303-636-5644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN WETHERINGTON
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 303-636-5796