Healthcare Provider Details
I. General information
NPI: 1174452114
Provider Name (Legal Business Name): ALIS BEHAVIORAL HEALTH OF COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8690 WOLFF CT STE 200
WESTMINSTER CO
80031-3697
US
IV. Provider business mailing address
1325 S COLORADO BLVD STE B705
DENVER CO
80222-3383
US
V. Phone/Fax
- Phone: 888-528-3860
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELI
GROSS
Title or Position: CEO
Credential:
Phone: 888-528-3860