Healthcare Provider Details

I. General information

NPI: 1609426386
Provider Name (Legal Business Name): SANDSTONE CARE COLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2019
Last Update Date: 09/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7555 E HAMPDEN AVE STE 103
DENVER CO
80231-4832
US

IV. Provider business mailing address

7555 E HAMPDEN AVE STE 103
DENVER CO
80231-4832
US

V. Phone/Fax

Practice location:
  • Phone: 720-420-7444
  • Fax: 888-850-1860
Mailing address:
  • Phone: 720-420-7444
  • Fax: 888-850-1860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARCELLO LA ROCCA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 240-743-3807