Healthcare Provider Details

I. General information

NPI: 1548551419
Provider Name (Legal Business Name): BHCF-R DENVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2011
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 INVERNESS DR E
ENGLEWOOD CO
80112-5115
US

IV. Provider business mailing address

135 INVERNESS DR E
ENGLEWOOD CO
80112-5115
US

V. Phone/Fax

Practice location:
  • Phone: 303-595-4263
  • Fax: 713-586-6752
Mailing address:
  • Phone: 303-595-4263
  • Fax: 713-586-6752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JO ANN JOHNSON
Title or Position: CREDENTIALING ASST
Credential:
Phone: 713-586-6778