Healthcare Provider Details

I. General information

NPI: 1467266817
Provider Name (Legal Business Name): ANANEO MHTLS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S SHERIDAN BLVD
LAKEWOOD CO
80226-3634
US

IV. Provider business mailing address

1600 RACE ST
DENVER CO
80206-1112
US

V. Phone/Fax

Practice location:
  • Phone: 303-276-0369
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH FRIEDMANN
Title or Position: OWNER
Credential:
Phone: 303-276-0369