Healthcare Provider Details

I. General information

NPI: 1962535229
Provider Name (Legal Business Name): COLORADO MENTAL HEALTH INSTITUTE FORT LOGAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 W OXFORD AVE
DENVER CO
80236-3108
US

IV. Provider business mailing address

3520 W OXFORD AVE
DENVER CO
80236-3108
US

V. Phone/Fax

Practice location:
  • Phone: 303-866-7080
  • Fax: 303-866-7088
Mailing address:
  • Phone: 303-866-7080
  • Fax: 303-866-7088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number0196
License Number StateCO

VIII. Authorized Official

Name: JASON FOLBIGG
Title or Position: CFO
Credential:
Phone: 303-720-5413