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General NPI Number Information
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NPI Number | 1326845553
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Entity Type | Organization
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Legal Business Name | COLORADO VOLUNTEERS IN JUVENILE CRIMINAL JUSTICE
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 800 N GRANT ST STE 224
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City | DENVER
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State | CO
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Zip | 80203-2944
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Country | US
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Telephone | 775-392-2657
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Fax |
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Provider Business Mailing Address
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Address Line | 2560 BUSINESS PKWY STE A
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City | MINDEN
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State | NV
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Zip | 89423-8961
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER, ROP
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Name | MARANDA FIGULI
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Credential |
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Telephone | 480-987-2080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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