Healthcare Provider Details

I. General information

NPI: 1134443294
Provider Name (Legal Business Name): TENNYSON CENTER FOR CHILDREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 01/19/2024
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 TENNYSON ST
DENVER CO
80212-3029
US

IV. Provider business mailing address

2950 TENNYSON ST
DENVER CO
80212-3029
US

V. Phone/Fax

Practice location:
  • Phone: 720-855-3244
  • Fax: 303-433-9701
Mailing address:
  • Phone: 720-855-3244
  • Fax: 303-433-9701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number5281
License Number StateCO

VIII. Authorized Official

Name: MINDY WATROUS
Title or Position: CEO
Credential:
Phone: 303-433-2541