Healthcare Provider Details

I. General information

NPI: 1144469578
Provider Name (Legal Business Name): COLORADO COALITION FOR THE HOMELESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 PARK AVE W
DENVER CO
80205-2605
US

IV. Provider business mailing address

2111 CHAMPA ST
DENVER CO
80205-2529
US

V. Phone/Fax

Practice location:
  • Phone: 303-244-0760
  • Fax: 303-292-2091
Mailing address:
  • Phone: 303-293-2217
  • Fax: 303-293-2309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: PETE J STOLLER
Title or Position: CFO
Credential:
Phone: 303-312-9606