Healthcare Provider Details

I. General information

NPI: 1497763262
Provider Name (Legal Business Name): PORTERCARE ADVENTIST HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S DOWNING ST
DENVER CO
80210-5817
US

IV. Provider business mailing address

PO BOX 713425
CHICAGO IL
60677-4325
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-1955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number1036
License Number StateCO

VIII. Authorized Official

Name: ANDREW WHITLOCK
Title or Position: CFO
Credential:
Phone: 303-778-5892