Healthcare Provider Details

I. General information

NPI: 1508074303
Provider Name (Legal Business Name): COLORADO NEUROLOGICAL INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E HAMPDEN AVE SUITE 330
ENGLEWOOD CO
80113-2759
US

IV. Provider business mailing address

701 E HAMPDEN AVE SUITE 330
ENGLEWOOD CO
80113-2759
US

V. Phone/Fax

Practice location:
  • Phone: 303-597-1724
  • Fax: 303-788-5469
Mailing address:
  • Phone: 303-597-1724
  • Fax: 303-788-5469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ELLEN B BELLE
Title or Position: NEUROHEALTH CENTER MANAGER
Credential: P.T.
Phone: 303-806-7421