Healthcare Provider Details

I. General information

NPI: 1902392004
Provider Name (Legal Business Name): THOUSAND PEAKS HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 E EVANS AVE STE 2-020
DENVER CO
80222-5420
US

IV. Provider business mailing address

6000 E EVANS AVE STE 2-020
DENVER CO
80222-5420
US

V. Phone/Fax

Practice location:
  • Phone: 303-252-4477
  • Fax:
Mailing address:
  • Phone: 303-252-4477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LEE JOHNSON
Title or Position: TREASURER
Credential:
Phone: 208-401-1369