Healthcare Provider Details

I. General information

NPI: 1497928014
Provider Name (Legal Business Name): COLORADO COALITION FOR THE HOMELESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 CHAMPA ST
DENVER CO
80205-2529
US

IV. Provider business mailing address

2111 CHAMPA ST
DENVER CO
80205-2529
US

V. Phone/Fax

Practice location:
  • Phone: 303-293-2217
  • Fax: 303-293-2309
Mailing address:
  • Phone: 303-293-2217
  • Fax: 303-293-2309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number50846
License Number StateCO

VIII. Authorized Official

Name: ELIZABETH COOKSON
Title or Position: DIRECTOR OF PSYCHIATRY
Credential: M.D.
Phone: 303-285-5290