Healthcare Provider Details

I. General information

NPI: 1922741370
Provider Name (Legal Business Name): BADGE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 05/27/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 ALCOTT ST
WESTMINSTER CO
80031-3819
US

IV. Provider business mailing address

8400 ALCOTT ST
WESTMINSTER CO
80031-3819
US

V. Phone/Fax

Practice location:
  • Phone: 720-507-3551
  • Fax:
Mailing address:
  • Phone: 720-507-3551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: KELLY KARINEN
Title or Position: CLINCIAN
Credential: LPCC, CAS
Phone: 720-660-3442