Healthcare Provider Details

I. General information

NPI: 1134730252
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 S ROUTT ST STE 300
LAKEWOOD CO
80228-2354
US

IV. Provider business mailing address

PO BOX 800022
KANSAS CITY MO
64180-0022
US

V. Phone/Fax

Practice location:
  • Phone: 720-321-8920
  • Fax: 720-321-9401
Mailing address:
  • Phone: 800-953-0104
  • Fax: 303-765-6670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA JO SKINNER
Title or Position: ADMINISTRATOR OMA
Credential:
Phone: 720-667-7283